The intra-articular efficacy of hyaluronate injections in the treatment of rheumatoid arthritis

To determine whether the intra-articular injection of hyaluronate (HA) is a potential clinical option for the treatment of rheumatoid arthritis (RA), we have evaluated the clinical efficacy of intra-articular corticosteroid and HA by analyzing the patient-based database from a cross-sectional observational cohort. A total of 668 (14.1%) of 4725 patients in the database received injections. The logistic regression analysis showed that the Japanese version of the Stanford Health Assessment Questionnaire functional index [J-HAQ; odds ratio (OR) 1.53, 95% confidence interval (CI) 1.35-1.73] and disease activity score 28 (DAS28; OR 1.28, 95% CI 1.19-1.39) were predictive in the case of receiving a joint injection compared to non-injection. The patient-perceived satisfactory rate of injection was 64.0 (95% CI 51.9-76.2) for corticosteroid injections and 59.3 (95% CI 50.6-67.9) for HA injections; however, there were no significant differences between the corticosteroid and HA injection groups (P < 0.074). Our results demonstrate that HA and corticosteroid injections generally have similar efficacy rates when the patient-perceived satisfactory rate was employed as an index. These results are encouraging, as the use of HA stimulates interest in clinical studies aimed at assessing the potential role of viscosupplementation in treating RA, and HA may represent another treatment option for RA.