Early decrease of
serum biomarkers of type II collagen degradation (Coll2-1) and joint
inflammation (Coll2-1 NO2 ) by hyaluronic acid intra-articular injections in
patients with knee osteoarthritis: A research study part of the Biovisco study
serum biomarkers of type II collagen degradation (Coll2-1) and joint
inflammation (Coll2-1 NO2 ) by hyaluronic acid intra-articular injections in
patients with knee osteoarthritis: A research study part of the Biovisco study
Henrotin
Y, Chevalier X, Deberg M, Balblanc JC, Richette P, Mulleman D, Maillet B,
Rannou F, Piroth C, Mathieu P, Conrozier T; Osteoarthritis Group of the French
Society of Rheumatology. J Orthop Res.
2013 Jun;31(6):901-7. doi: 10.1002/jor.22297. Epub 2013 Feb 19.
Y, Chevalier X, Deberg M, Balblanc JC, Richette P, Mulleman D, Maillet B,
Rannou F, Piroth C, Mathieu P, Conrozier T; Osteoarthritis Group of the French
Society of Rheumatology. J Orthop Res.
2013 Jun;31(6):901-7. doi: 10.1002/jor.22297. Epub 2013 Feb 19.
Take Home Message: Hyaluronic acid injections decrease factors
related to collagen degradation. Some blood tests may differentiate responders
and nonresponders to these injections.
related to collagen degradation. Some blood tests may differentiate responders
and nonresponders to these injections.
Knee
osteoarthritis, one of the leading causes of disability, has no cure and
current treatments commonly involve medications to decrease inflammation and
pain. Hyaluronic acid (HA) injections
have become a popular form of treatment for knee osteoarthritis. However, the mechanism of action has yet to
be determined. Therefore, the authors
examined serum biomarkers of collagen breakdown (Coll2-1 and Coll2-1 NO2)
in 45 patients with various stages of knee osteoarthritis before (-15 days), at
the time of injection, and following treatment (30 and 90 days) with HA
injections. The authors collected serum
and demographic data (age, sex, height, weight, date of diagnosis, osteoarthritis
in other joints, and concomitant treat for osteoarthritis) and examined the
knee (pain, stiffness, swelling, effusion, walking and global pain using a VAS). They determined the stage of knee
osteoarthritis based on x-rays obtained for both knees at the start of the
study. Walking and global pain decreased
from day 1 to day 90. Of the 45 patients
26 responded well to the injections (based on a greater than 50% reduction in
walking and global pain) while the remaining 19 patients did not. The response was unrelated to age, sex, body
mass index, disease duration, stage of knee osteoarthritis, or previous
treatments. The serum biomarkers of
cartilage breakdown decreased following HA injections with patients with
end-stage knee osteoarthritis having a more substantial decrease. At baseline (-15 days) the responsive group
had lower levels of one of the markers of collagen turnover (Coll2-1) compared with
the unresponsive group.
osteoarthritis, one of the leading causes of disability, has no cure and
current treatments commonly involve medications to decrease inflammation and
pain. Hyaluronic acid (HA) injections
have become a popular form of treatment for knee osteoarthritis. However, the mechanism of action has yet to
be determined. Therefore, the authors
examined serum biomarkers of collagen breakdown (Coll2-1 and Coll2-1 NO2)
in 45 patients with various stages of knee osteoarthritis before (-15 days), at
the time of injection, and following treatment (30 and 90 days) with HA
injections. The authors collected serum
and demographic data (age, sex, height, weight, date of diagnosis, osteoarthritis
in other joints, and concomitant treat for osteoarthritis) and examined the
knee (pain, stiffness, swelling, effusion, walking and global pain using a VAS). They determined the stage of knee
osteoarthritis based on x-rays obtained for both knees at the start of the
study. Walking and global pain decreased
from day 1 to day 90. Of the 45 patients
26 responded well to the injections (based on a greater than 50% reduction in
walking and global pain) while the remaining 19 patients did not. The response was unrelated to age, sex, body
mass index, disease duration, stage of knee osteoarthritis, or previous
treatments. The serum biomarkers of
cartilage breakdown decreased following HA injections with patients with
end-stage knee osteoarthritis having a more substantial decrease. At baseline (-15 days) the responsive group
had lower levels of one of the markers of collagen turnover (Coll2-1) compared with
the unresponsive group.
This
study was successful at identifying that biomarkers of collagen breakdown,
which are typically associated with knee osteoarthritis, can be reduced with HA
injections. The authors also found that there
were two categories of patients: responders and non-responders. This is observed clinically as well with some
patients having great results while others do not benefit. When dividing the patients into these groups
they found that one specific biomarker was lower at the baseline measure (-15
days) in the responsive group. This is a
clinically relevant finding that demonstrates a possible effective way of
identifying patients that will respond favorably to the HA injections. The ability to identify patients that will
benefit from a specific treatment would significantly improve patient outcomes
and reduce healthcare costs. These type
of biomarkers could also be helpful for other treatments in sports medicine. Research
like this will help to advance the medical field to provide more patient
specific treatment and improve our ability to help patients.
study was successful at identifying that biomarkers of collagen breakdown,
which are typically associated with knee osteoarthritis, can be reduced with HA
injections. The authors also found that there
were two categories of patients: responders and non-responders. This is observed clinically as well with some
patients having great results while others do not benefit. When dividing the patients into these groups
they found that one specific biomarker was lower at the baseline measure (-15
days) in the responsive group. This is a
clinically relevant finding that demonstrates a possible effective way of
identifying patients that will respond favorably to the HA injections. The ability to identify patients that will
benefit from a specific treatment would significantly improve patient outcomes
and reduce healthcare costs. These type
of biomarkers could also be helpful for other treatments in sports medicine. Research
like this will help to advance the medical field to provide more patient
specific treatment and improve our ability to help patients.
Questions for
Discussion: Do your patients have success with HA injections? Do you think the use of biomarkers and
genetics will be used routinely to guide our treatment options?
Discussion: Do your patients have success with HA injections? Do you think the use of biomarkers and
genetics will be used routinely to guide our treatment options?
Written
by: Stephen Thomas
by: Stephen Thomas
Reviewed
by: Jeffrey Driban
by: Jeffrey Driban
Related
Posts:
Posts:
Henrotin Y, Chevalier X, Deberg M, Balblanc JC, Richette P, Mulleman D, Maillet B, Rannou F, Piroth C, Mathieu P, Conrozier T, & Osteoarthritis Group of the French Society of Rheumatology (2013). Early decrease of serum biomarkers of type II collagen degradation (Coll2-1) and joint inflammation (Coll2-1 NO2 ) by hyaluronic acid intra-articular injections in patients with knee osteoarthritis: A research study part of the Biovisco study. Journal of Orthopaedic Research, 31 (6), 901-7 PMID: 23423846