Oral Hyaluronic Acid in Osteoarthritis and Low Back Pain: A Systematic Review.

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Background: Hyaluronic acid (HA) has been largely used in clinical practice for rheumatic diseases. However, the effects of oral HA on these diseases are poorly understood.Aim: To review articles evaluating oral HA's effects on rheumatic patients.Methods: PubMed was searched for articles on oral HA and rheumatic diseases between 1966 and May 2024.Results: Eleven articles were found with 597 patients. The diseases investigated were OA (n=10) and low back pain (n=1). Age varied from 40 to 70 years old, and female gender ranged from 43% to 75%. Follow-up ranged from 4 weeks to 12 months. The oral HA dosage varied from 30 mg to 300 mg/day. Concerning outcome, 9/11 articles observed improvement in rheumatic diseases in the following parameters: VAS pain, WOMAC, joint function, SF-36, Lequesne index, and stiffness. Two studies evaluated cytokines and observed a reduction of them after oral HA therapy. Adverse effects were rare and mild.Conclusion: Oral HA seems to be a safe and effective therapy for OA and low back pain patients, although more studies should be done on the latter condition.