Comparative clinical, pharmacological, and pharmacoeconomic evaluation of various intra-articular hyaluronic acid administration regimens for knee osteoarthritis

Zyryanov S.K., Bondarev A.V.

Peoples’ Friendship University of Russia named after Patrice Lumumba, Moscow, Russia

Background: Intra-articular hyaluronic acid (HA) administration is a common method for the symptomatic treatment of knee osteoarthritis (OA). Various HA administration regimens are used in clinical practice; however, the rational choice of treatment frequency, taking into account clinical efficacy and cost effectiveness, remains poorly understood.
Objective: Comparative evaluation of the clinical efficacy and pharmacoeconomic feasibility of single- and triple-dose hyaluronic acid administration regimens in patients with knee osteoarthritis. Material and methods: Data from an observational study including 216 patients with knee OA (108 patients in each group) were analyzed. Patients received HA therapy according to two regimens: a single administration of the cross-linked form and three administrations of the linear form. Efficacy was assessed based on changes in WOMAC scores, the visual analogue scale (VAS), the self-assessment scale, and the EQ-5D-3L. A pharmacoeconomic analysis of direct medical costs was additionally performed, taking into account the cost of medications and the intra-articular injection procedure.
Results: Statistically significant improvements in clinical and functional parameters were noted in both groups. After treatment, a decrease in pain severity according to the VAS, a reduction in the total WOMAC score, and an improvement of quality of life indicators were observed. No intergroup differences in key clinical parameters were found, indicating comparable efficacy of the different treatment regimens. Adverse events were predominantly mild, with no statistically significant differences between the groups. A pharmacoeconomic analysis showed that, with comparable clinical efficacy, a single-dose regimen was associated with reduced direct costs due to a reduced number of procedures. The total cost of treatment with the single-dose regimen was lower compared to the triple-dose regimen.
Conclusion: Single and triple-dose hyaluronic acid administration for knee osteoarthritis exhibit comparable clinical efficacy and safety. Moreover, the single-dose regimen is more cost-effective, which can be considered as a factor in choosing a treatment strategy.

For citations: Zyryanov S.K., Bondarev A.V. Comparative clinical, pharmacological, and pharmacoeconomic evaluation of various intra-articular hyaluronic acid administration regimens for knee osteoarthritis. Pharmateca. 2026;33(1):50-55. (In Russ.). DOI: https://dx.doi.org/10.18565/pharmateca.2026.1.50-55

Authors’ contribution: The authors contributed to the study: study concept and design; clinical data processing; statistical and pharmacoeconomic analysis; interpretation of the results; manuscript preparation and editing. All authors approved the final version of the article and are responsible for its content.
Conflicts of interest: The authors confirm that they have no conflicts of interest to declare.
Funding: The study was conducted without any sponsorship.
Ethical Approval: The study was approved by the local Ethics Committee of the Peoples’ Friendship University of Russia named after Patrice Lumumba (minutes of meeting No. 10 dated April 8, 2025).
Patient Consent for Publication: All patients provided informed consent for the publication of their data.
Authors’ Data Sharing Statement: The data supporting the findings of this study are available upon request from the corresponding author after approval from the principal investigator.

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About the Authors

S.K. Zyryanov, Dr. Sci. (Med.), Professor, Head of the Department of General and Clinical Pharmacology, Peoples’ Friendship University of Russia named after Patrice Lumumba, Moscow, Russia; ORCID: https://orcid.org/0000-0002-6348-6867
Anatoly V. Bondarev, Postgraduate Student, Department of General and Clinical Pharmacology, Peoples’ Friendship University of Russia named after Patrice Lumumba, Moscow, Russia; 1142221175@rudn.ru, ORCID: https://orcid.org/0009-0009-5286-1463 (corresponding author)

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