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In knee osteoarthritis, a single intra-articular injection of mannitol + hyaluronan improves functional outcomes.
A double-blind randomized clinical trial evaluating mannitol-combined hyaluronan (JETKNEE) provides new evidence in knee osteoarthritis (OA) management, showing substantial functional benefits despite no added pain relief over placebo.
Hyaluronic acid (HA) injections are widely used for knee OA but are prone to rapid degradation by reactive oxygen species. JETKNEE, a formulation of non-crosslinked HA (20 mg/ml) with 0.5% mannitol, is designed to enhance HA stability and prolong intra-articular effects. Hence, this study investigated single intra-articular JETKNEE injection for symptomatic knee OA.
In total, 132 patients suffering from Kellgren–Lawrence grade 2–3 OA received a single 2 ml intra-articular injection of JETKNEE or saline. The key endpoint was the change in visual analog scale (VAS) pain at 6 months, alongside functional and structural secondary outcomes. Both groups experienced remarkable reductions in VAS pain, with no difference between JETKNEE and placebo, depicting the primary endpoint was not met. However, JETKNEE exhibited remarkably greater improvement in function, WOMAC pain, and total scores across all time points, along with faster early improvement in the Lequesne index.
No prominent differences were noted in cartilage thickness, quadriceps muscle thickness, or OA grading on ultrasound, and patient satisfaction remained similar between groups. While adverse events were more frequent with JETKNEE, they were mostly mild, supporting a favorable safety profile.
The Knee
Efficacy and safety of a single intra-articular injection of mannitol-combined hyaluronan in patients with knee osteoarthritis – A double-blinded randomized clinical study
Chun-Yu Chen et al.
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