30 research outputs found

    Intraarticular Hyaluronic Acid Preparations for Knee Osteoarthritis: Are Some Better Than Others?

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    Objective This literature review summarizes evidence on the safety and efficacy of intraarticular hyaluronic acid (IAHA) preparations approved in the United States for the treatment of osteoarthritis of the knee. Design A systematic literature search was performed in PubMed, Ovid MEDLINE, and SCOPUS databases. Only studies in which clinical outcomes of individual IAHA preparations alone could be assessed when compared to placebo, no treatment, other standard knee osteoarthritis treatments, and IAHA head-to-head studies were selected. Results One hundred nine articles meeting our inclusion criteria were identified, including 59 randomized and 50 observational studies. Hylan G-F 20 has been the most extensively studied preparation, with consistent results confirming efficacy in placebo-controlled studies. Efficacy is also consistently reported for Supartz, Monovisc, and Euflexxa, but not for Hyalgan, Orthovisc, and Durolane. In the head-to-head trials, high-molecular-weight (MW) Hylan G-F 20 was consistently superior to low MW sodium hyaluronate preparations (Hyalgan, Supartz) up to 20 weeks, whereas one study reported that Durolane was noninferior to Supartz. Head-to-head trials comparing high versus medium MW preparations all used Hylan G-F 20 as the high MW preparation. Of the IAHA preparations with strong evidence of efficacy in placebo-controlled studies, Euflexxa was found to be noninferior to Hylan G-F 20. There are no direct comparisons to Monovisc. One additional IAHA preparation (ie, Synovial), which has not been assessed in placebo-controlled studies, was also noninferior to Hylan G-F 20. Conclusion IAHA efficacy varies widely across preparations. High-quality studies are required to assess and compare the safety and efficacy of IAHA preparations. </jats:sec

    Evaluation of Hylan G-F 20 Treatment with Opioid Prescriptions and Intraarticular Corticosteroid Injections in Patients with Osteoarthritis of the Knee Using a Claims Database

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    Objective Assess how treatment with the viscosupplement hylan G-F 20 relates to opioid prescriptions and intraarticular corticosteroid injections (IACS) in patients with osteoarthritis of the knee (OAK). Design Case-crossover; adult patients with OAK identified in a claims database were treated with hylan G-F 20 from July 1, 2007, to June 29, 2017. Opioid or IACS prescriptions in the 6 months before treatment were compared to the 6 months after. Patients with comorbid conditions requiring pain medications were excluded, resulting in a 29,395-patient cohort. Four subgroups were investigated: patients with (1) opioids before hylan G-F 20 (OB; n = 6,609); (2) opioids before and after hylan G-F 20 (OBF; n = 3,320); (3) IACS before hylan G-F 20 (CB; n = 11,162); and (4) IACS before and after hylan G-F 20 (CBF; n = 2,810). All opioids were converted to morphine milligram equivalents (MME). Results OB subgroup patients had a significant decrease ( P &lt; 0.01) in total MME (−14.0%), MME per day (−14.2%) and opioid prescription days (−12.6%) after treatment versus before. Only 50.2% of patients prescribed opioids before hylan G-F 20 were prescribed an opioid after treatment. OBF subgroup patients had a significant increase ( P &lt; 0.01) in opioid prescription days (7.8%) before versus after treatment. There was a significant decrease ( P &lt; 0.01) in the number of IACS after versus before treatment for the Total Cohort (−56.1%), and subgroups CB (−72.6%) and CBF (−4.1%). A total of 74.8% of patients receiving an IACS before treatment did not receive an IACS after treatment. Conclusions Hylan G-F 20 is associated with a reduction in opioid prescriptions and IACS in OAK patients. </jats:sec

    Bewusstsein und Bekämpfung pandemischer Gefahren

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    Während der COVID-19-Pandemie ist die Zahl der Fahrgäste in öffentlichen Verkehrsmitteln erheblich zurückgegangen. Die Mission der DLR Graduierten Schule "GANDALF" ist, den öffentlichen Verkehr gegen pandemische Gefahren zu sichern, indem Methoden zur Reduzierung der Keimlast in öffentlichen Verkehrsmitteln entwickelt und anhand von mikrobiellen Modellorganismen und einer mikrobiellen Gemeinschaft zu getestet werden. Unsere Stärke liegt in der interdisziplinären Zusammenarbeit von neun Promovierenden aus jeweils verschiedenen DLR-Instituten, die jeweils einen eigenen Forschungsschwerpunkt und eine eigene Expertise haben, um die Herausforderungen von zukünftigen Pandemien anzugehen
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