Hip viscosupplementation under ultra-sound guidance riduces NSAID consumption in symptomatic hip osteoarthritis XXXX in a long follow-up. Data from Italian registry.

@entity1 @entity571 @entity158 @entity4023
INTRODUCTION: Non-steroidal anti-inflammatory drugs (NSAIDs) consumption is strictly related to a high gastrointestinal and cardiovascular mortality and morbidity rate. @entity571 Research Society International (OARSI) recommendations in @entity1 with symptomatic hip or knee @entity571 stated that NSAIDs should be used at the lowest effective dose but their long-term use should be avoided if possible. OARSI guidelines for the treatment of the hip @entity571 include the use of viscosupplementation, which aims to restore physiological and rheological features of the synovial fluid. OBJECTIVE: Aim of this multicentric, open and retrospective study is to investigate if NSAID consumption may be reduced by the use of ultrasound-guided intra-articular injection of several hyaluronic acid (HA) products in hip joint administered in @entity1 affected by symptomatic hip @entity571 . MATERIALS AND METHODS: @entity1 affected by mono or bilateral symptomatic hip @entity571 according to American Rheumatology Association (ARA) criteria, radiological @entity571 graded II-IV (Kellgren and Lawrence) entered the study and were administered with ultrasound-guided intra-articular injection of @entity4023 products. As a primary endpoint, consumption of NSAIDs was evaluated by recording the number of days a month (range 0-30) the @entity1 had used NSAID during the previous month, reported at each visit during the 24 months follow-up period. Secondary endpoints included further analysis for subgroups of @entity1 categorized for Lequesne index score, Kellgren-Lawrence score, pain visual analogue scale (VAS) score, ultrasound pattern, age, hyaluronic acid used. RESULTS: 2343 @entity1 entered the study. Regarding primary endpoint, the consumption of NSAIDs was reduced of 48.2% at the third month when compared with baseline values. This sparing effect increased at 12th and 24th month with a reduction respectively of 50% and 61% in comparison to baseline values. These differences were statistically significant. CONCLUSIONS: These data point out that intraarticular hyaluronan preparations provide @entity158 relief and reduce NSAIDs consumption in a large cohort of @entity1 for a long period of follow-up. Multiple courses of viscosupplementation (vs) are required to maintain low dose of NSAID consumption over time. NSAIDs consumption is strictly related to an high gastrointestinal and cardiovascular mortality and morbidity rate, instead HA intra-articular treatment is well tolerated and is associated with a low incidence of adverse effects. For these reasons further studies evaluating cost-effectiveness and cost-utility of VS in the management of hip @entity571 are required.
