▸ Second, that the repeat series of injections were safe with this bacteria-derived product; there was no increase in adverse events.
▸ Third – which is a new finding to my knowledge – is that there is a subset of patients who don't respond to the initial series of injections but who did respond to repeat series of injections.
▸ Fourth – this is the first controlled study to my knowledge that has demonstrated benefit lasting for at least a year following the repeated series of injections.
Statistically, they used the OMERACT-OARSI responder criteria, a robust technique that separates responders and nonresponders.
This is the kind of study that reinforces the way I practice and may even change it. If I have someone with only a borderline response to the first injections, I now might give it a second try.
One thing I do question is the dropout rate. With a dropout rate of 27% in the treatment group and 39% in the saline group, you wonder if the significance of the findings would change if they had completed the trial.
ROY ALTMAN, M.D., is professor of rheumatology and immunology at the University of California, Los Angeles. He reported having no financial relationship to disclose relevant to Adant. Dr. Altman said that he consults for Ferring, Fidia, Novozyme, and Smith & Nephew/Q-Med, all of which make other hyaluronic acid products.
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