Hylan G-F 20 tolerability with repeat treatment in a large orthopedic practice: a retrospective review

The objective of this study was to determine the incidence of local adverse events (AEs) with repeat treatment of hylan G-F 20 for osteoarthritis (OA) knee pain relief in the authors' practice. Prospectively collected patient data (5-year period) was retrospectively reviewed from patients who initiated multiple courses of three weekly hylan G-F 20 injections. All local AEs (knee pain and swelling) were qualitatively and quantitatively assessed. The incidence of treatment-related local AEs was 3.4% of patients (0.8% of injections) at course 1, 13.1% of patients (4.3% of injections) at course 2, and 17.3% of patients (5.4% of injections) at course 3. The majority of related local AEs were mild to moderate and persisted for < or = 48 hours. The number of patients who discontinued injections because of local AEs was low. While the incidence of local AEs with hylan G-F 20 tends to slightly increase with subsequent courses of therapy, physicians should educate patients regarding this possibility rather than preclude them from the benefit of continued OA pain relief with repeat hylan G-F 20 therapy.