Evaluation of Intra-Articular Polysulfated Glycosaminoglycan and Sodium Hyaluronan for Treatment of Osteoarthritis Using an Equine Experimental Model.

1. Introduction

Few randomized, placebo-controlled studies evaluating the effectiveness of polysulfated glycosaminoglycan (PSGAG) and sodium hyaluronan (HA) on equine osteoarthritis (OA) have been performed; thus, these therapeutic agents were critically evaluated in this study.

2. Materials and Methods

This study was a double-blinded, experimentally controlled, randomized block design using 24 horses in an established model of OA. OA was induced in one carpal joint of each horse. On days 14, 21, and 28, horses received one of three intra-articular treatments: (1) 250 mg PSGAG [a] and 125 mg amikacin [b] (2) 22 mg sodium hyaluronan [c] and 125 mg amikacin, and (3) 2 ml 0.9% NaCl and 125 mg amikacin (PCB). Clinical, biochemical, gross, and histologic outcome parameters were objectively measured. Data were analyzed using a combination of analysis of variance matrixes; a p value of ≤0.05 was considered statistically significant.

3. Results

No adverse treatment-related events were detected. Although the model induced a significant change in clinical parameters, no significant treatment effects were shown with the exception of improvement in synovial fluid effusion with PSGAG when compared with PCB. Histologically, the degree of synovial membrane vascularity and subintimal fibrosis were significantly reduced with PSGAG treatment compared with PCB. A trend of similar results was seen in synovial membranes of HA-treated horses. Histologically, significantly less fibrillation was seen with HA treatment, and a similar trend was observed with PSGAG compared with PCB.

4. Discussion

Results of this study indicated that PSGAG and HA had beneficial effects that could classify them as disease-modifying OA drugs. As such, both are viable therapeutic options for equine osteoarthritis.

This study was funded in part by Luitpold Pharmaceuticals.

Footnotes

1. Adequan I.A.® (Polysulfated Glycosaminoglycan) (PSGAG), Luitpold Pharmaceuticals, Inc., Animal Health Division, Shirley, NY 11967.
2. Amikacin® (Sulfate injection, USP), Sicor Pharmaceuticals, Inc., Irvine, CA 92618.
3. Hyvisc® (Hyaluronate Sodium), Anika Therapeutics, Inc., Woburn, MA 01801.