Osteoarthritis Of Knee Clinical Trial
Official title:
A Randomized Placebo Controlled Trial to Assess the Structural Effect and Long-term Symptomatic Relief of Repeated Intra-articular Injections of Hyaluronic Acid in Primary Knee Osteoarthritis
The present study is designed to test the hypothesis that Intra-Articular Hyaluronic Acid
(IAHA) is superior to placebo in slowing structural progression and on long term symptomatic
effect in primary knee Osteoarthritis (OA) patients.
The investigators will perform a multicenter double-blind, randomized, placebo-controlled,
parallel group trial.
The target population will be patients with the diagnosis of knee osteoarthritis who are
followed at two Portuguese hospitals (Centro Hospitalar de Lisboa Norte - Hospital Santa
Maria, Centro Hospitalar de Lisboa Ocidental - Hospital Egas Moniz).
All patients selected will be included in the intention-to-treat group. Then, using blocked
randomization method they will be assigned to receive either IAHA, or placebo (saline
solution). At both hospitals the study will consist of four injections of IAHA, 6 months
apart, plus a 6 month period after the injection, resulting in a total follow-up period of
24 months. Before each new cycle a follow-up consultation will be performed in order to
assess pain and function (KOOS), quality of life (SF-36), adverse events and consumption of
acetaminophen and NSAIDS regarding the week before evaluation. X-rays will be performed in
the beginning of follow-up, one year after that and 6 months after the last cycle of IAHA or
placebo injections (24 months).
Ultrasound evaluation will be performed at the target knee in same time points as X-rays by
two rheumatologists trained in musculoskeletal ultrasound examination. Additionally, the
investigators will assess potential biochemical biomarkers of knee OA structural progression
and response to treatment. Measurements will be performed in both serum and urine and, If
possible, synovial fluid aspiration will be performed and together with blood and urine
samples stored at the Biobanco-IMM Instituto de Medicina Molecular for analysis. Biologic
samples collection will be performed at baseline and repeated at the 4th, 12th, 24th, 36th
weeks, and then every 6 months.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment
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