LABRHA at the ISIAT Congress in Prague in October 2017

The 4th edition of the International Symposium on Intra-Articular Treatment (ISIAT) took place in Prague last 5th to 7th of October 2017.

Organized every two years across different European cities by Prof. Alberto Migliore (IT), this congress is, as its name suggests, focus on intra-articular management of joint disease including intra-articular access, therapeutic targets and tools as well as future developments.

Theory and practice are mixed during this event. Indeed while lectures, speeches by leading experts, research findings presentations, round tables and debates take place, practical sessions, dealing with various aspects of US-guided injection techniques, are concurrently held. In total this year, more than 90 presentations examined the topic from all sides and helped understand where things stand in 2017 regarding intra-articular treatments.

Among the different therapeutic options available today in daily practice, Hyaluronic Acid (HA), alone or combined (with mannitol, sorbitol, triamcinolone hexacetonide) as well as PRP took center stage.

As for the past 3 editions of ISIAT, LABRHA participated at this congress presenting its latest scientific works in 3 oral communications:

1 // Recommendations from the EUROVISCO Group on Retreatment with Viscosupplementation in Patients Suffering from Knee Osteoarthritis. Raman R et al.

During the 2^nd LABRHA European Board on Viscosupplementation, which took place last 17^th-18th of September 2015, the EUROPEAN CONSENSUS GROUP on VISCOSUPPLEMENTATION built two decision algorithms to help practitioners in the retreatment of patients with knee osteoarthritis who had previously been treated with viscosupplementation.

• the 1^st algorithm gives recommendations for retreatment with viscosupplementation of patients after failure of a previous viscosupplementation

• the 2nd algorithm is intended to help physicians decide when and how retreat patients successfully treated by a previous viscosupplementation

2 // Multicenter Open-Label Trial assessing Safety and Efficacy of a Single Injection of Mannitol-Modified Crosslinked Hyaluronic Acid (Happymini®) in Trapezometacarpial Osteoarthritis. Lellouche H et al.

This 3 month prospective multicentre open-label study has been conducted in patients suffering from TMC OA and not adequately relieved by analgesics/NSAIDs therapy and/or by the use of a thumb orthosis to:

• assess the safety and efficacy on pain relief of a single intra-articular injection of a mannitol-modified cross-linked hyaluronic acid (HAppyMini®),

• study the predictive factors of response to viscosupplementation with a single injection of HAppyMini®

106 patients were recruited. 3 months following a single injection of HAppyMini® in the TMC joint under fluoroscopic or ultrasound guidance, pain decreased significantly from 6.5 to 3.6 (p<0.0001).

Pain decrease was unrelated to Dell grade, level of pain on VAS at baseline or disease duration, suggesting that viscosupplementation with HAppyMini® remains indicated including in patients with the more advanced stages of OA.

.

3 // The rate of response to viscosupplementation is depending on the choice of the Patient Reported Outcomes (PROs) in patients with knee osteoarthritis. Conrozier T et al.

Authors have reported the results of a post-hoc analysis of a recently published 6 month open-label clinical trial which showed the efficacy and tolerance of HAppyCross in knee OA.

They studied the percentage of patients who reached the PASS threshold (PASS +), 6 months after a single intra-articular injection of HAppyCross in the knee, and compared it with that obtained from other PROs.

The overall percentage of responders was 80% in daily practice but varied according to PROs. PASS was better related to patients perception of pain and level of satisfaction than the decrease of WOMAC score showing that PASS might be a relevant and useful tool to evaluate the effectiveness of viscosupplementation.

.

This international congress is also a good opportunity to remind that LABRHA and its R&D department have been directly involved in 17 international publications since 2014 including 14 in the field of viscosupplementation making LABRHA an international leader in this field.

As usual since 2011, LABRHA will participate at the XXXI Congress of the French Society of Rheumatology which will took place in Paris next 9th to 11th of December 2017 and present 2 oral presentations as well as 3 posters.