A randomized controlled trial for comparing efficacy and safety between intraarticular polynucleotide and hyaluronic acid for knee osteoarthritis treatment
Open accessAbstract
Although the use of intra-articular polynucleotide (IA PN) injection as a viscosupplement for knee osteoarthritis (OA) treatment has been proposed, its efficacy and safety compared to high molecular weight hyaluronic acid (HMWHA) injection has not yet been established. The present double-blind, multicenter, randomized controlled trial aimed to investigate the efficacy and safety of IA PN injection compared to IA HMWHA injection. A total of 60 patients (15 men, 45 women, 64.5 ± 7.5 years) with knee OA (Kellgren–Lawrence grade 1–4) were randomly allocated to each group. All patients were given three IA injections of PN (n = 30) or HMWHA (n = 30) at intervals of 1 week. The primary endpoint was the change rate in weight-bearing pain (WBP) 16 weeks from the baseline. The secondary endpoint included multiple measurements: the change rate in WBP rate at 8 weeks; the change rate in pain level at rest and during walking at 8 and 16 weeks; the Korean-Western Ontario and McMaster University Osteoarthritis index; the Euro-Quality of Life-5 Dimension; Clinical Global Impression, Patient Global Impression at 8 and16 weeks, and total consumption of rescue medicine. The mean change rate in the WBP at 16 weeks from the baseline was − 54.0 ± 38.1% in the IA PN group and − 42.8 (± 35.8%) in the IA HMWHA group, and there was no significant difference between the two groups ( p = 0.296). All secondary endpoints related with pain and functional outcome also showed no significant difference between the two groups. Pain at the injection site and swelling were reported as adverse events, and the incidence was similar between the two groups. IA PN showed comparable efficacy and safety to IA HMWHA at 3 times injection with an interval of 1 week. IA PN can be useful alternative to IA HMWHA for the treatment of knee OA.
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PN has shown favorable outcomes in improving knee function and alleviating pain without causing serious adverse effects.
“In addition, PN has shown favorable outcomes in improving knee function and alleviating pain without causing serious adverse effects [42,43,44,45,46,47].”
From Comparison of Polynucleotide and Polydeoxyribonucleotide in Dermatology: Molecular Mechanisms and Clinical Perspectives (2025) · cites this paper as [44]
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- Authors
- Kim, T. W., Chang, M. J., Shin, C. Y., Chang, C. B., & Kang, S.-B.
- Affiliations
- Seoul National University (KR)
- Corresponding author
- Kang, Seung-Baik
- Venue
- Scientific Reports
- Published
- 2023-06-09
- Volume
- 13
- Issue
- 1
- Pages
- 9419-9419
- ISSN
- 2045-2322 (ISSN-L)
- PMC
- PMC10256705
- OpenAlex
- W4380084740
- Cited by
- 24
- References
- 31
- Citations by year
- 2026: 8 · 2025: 9 · 2024: 4 · 2023: 3
- FWCI
- 5.03
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Scientific Reports (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Rheumatology › Osteoarthritis Treatment and Mechanisms
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cell Biology › Proteoglycans and glycosaminoglycans research
- Health Sciences › Medicine › Urology › Periodontal Regeneration and Treatments
- Keywords
- knee osteoarthritis, intra-articular injection, polynucleotides, hyaluronic acid, viscosupplementation, weight-bearing pain, treatment efficacy, treatment safety, adverse events, quality of life, functional outcome
- MeSH terms
- Double-Blind Method, Female, Humans, Hyaluronic Acid, Injections, Intra-Articular, Male, Pain, Quality of Life, Treatment Outcome, Osteoarthritis, Knee
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