How Hyalgan Is Used to Treat Knee Osteoarthritis

Why Hyalgan – Hyalgan

How Hyalgan Is Used to Treat Knee Osteoarthritis

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Source: https://hyalgan.com/patients/why-hyalgan/

Intra-articular injections of sodium hyaluronate (Hyalgan ® ) in osteoarthritis of the knee. a randomized, controlled, double-blind, multicenter trial in the asian population

How Hyalgan Is Used to Treat Knee Osteoarthritis

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How Hyalgan Is Used to Treat Knee Osteoarthritis

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How Hyalgan Is Used to Treat Knee Osteoarthritis

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Drugs & Medications

How Hyalgan Is Used to Treat Knee Osteoarthritis
Drugs & Medications

  • Uses
  • Side Effects
  • Precautions
  • Interactions
  • Overdose
  • Images
  • Uses
  • Side Effects
  • Precautions
  • Interactions
  • Overdose
  • Images

Uses

This medication is used to treat knee pain in patients with joint inflammation (osteoarthritis).

It is usually used in patients who have not responded to other treatments such as acetaminophen, exercise, or physical therapy. Hyaluronate (also known as hyaluronan) is similar to a substance that occurs naturally in the joints. It may work by acting as a lubricant and shock absorber in the joint, helping the knee to move smoothly, thereby lessening pain.

Read the Patient Information Leaflet provided by your health care professional before you start using hyaluronate and each time you get a refill. If you have any questions, ask your doctor or pharmacist.

Your doctor will give this medication by injection into the affected joint, usually once a week. Skin disinfectants that contain ammonium salts (such as benzalkonium chloride) should not be used to prepare the injection site. Your doctor may need to remove extra fluid from the joint before injecting the medicine. Dosage is your medical condition and response to treatment.

Hyaluronate should not be injected into a vein or artery because increased side effects may occur.

After receiving an injection of hyaluronate, you should avoid any activities that put stress on your knee (such as jogging, tennis, heavy lifting, standing on your feet for more than an hour) for 48 hours.

Also, after the injection, you may experience increased pain and swelling in the knee at first. If the pain or swelling continues or worsens, talk to your doctor promptly.

It is important to have this medication injected on schedule. It may take up to 3 injections before the full benefits of this medication occur.

Tell your doctor if your condition persists or worsens.

Side Effects

See also How to Use section.

Pain, swelling, redness/warmth/bruising at the injection site, or headache may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if you have any serious side effects, including: back pain, severe headache, fast/pounding heartbeat, fever, tingling skin.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US –

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

Source: https://www.webmd.com/drugs/2/drug-4060/hyalgan-intra-articular/details

Benefits of Hyalgan – Hyalgan

How Hyalgan Is Used to Treat Knee Osteoarthritis

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  2. Hammesfahr JFR, Knopf AB, Stitik T. Safety of intra-articular hyaluronates for pain associated with osteoarthritis of the knee. Am J Orthop. 2003;32(6):277-283.

  3. Kelly MA, Goldberg VM, Healy WL, Pagnano MW, Hamburger MI. Osteoarthritis and beyond: a consensus on the past, present, and future of hyaluronans in orthopedics. Orthopedics. 2003;26(10):1064-1079.

  4. HYALGAN®, data on file. Fidia Farmaceutici S.p.A., Italy.

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  7. Bragantini A, Cassini M, De Bastiani G, Perbellini A. Controlled single-blind trial of intra-articularly injected hyaluronic acid (HYALGAN®) in osteo-arthritis of the knee. Clin Trials J. 1987;24(4):333-340.

  8. Grecomoro G, Martorana U, Di Marco C. Intra-articular treatment with sodium hyaluronate in gonarthrosis: a controlled clinical trial versus placebo. Pharmatherapeutica. 1987;5(2):137-141.

  9. Scali JJ. Intra-articular hyaluronic acid in the treatment of osteoarthritis of the knee: a long term study. Eur J Rheumatol Inflamm. 1995;15(1):57-62.

  10. Ghosh P, Guidolin D. Potential mechanism of action of intra-articular hyaluronan therapy in osteoarthritis: are the effects molecular-weight dependent? Semin Arthritis Rheum. 2002;32(1):10-37.

  11. Balazs E. The physical properties of synovial fluid and the specific role of hyaluronic acid. In: Helfet AJ, ed. Disorders of the Knee. 2nd ed. Philadelphia, PA: JB Lippincott; 1982:61-74.

  12. Gotoh S, Miyazaki K, Onaya J, Sakamoto T, Tokuyasu T, Namiki O. Experimental knee pain model in rats and analgesic effect of sodium hyaluronate (SPH) [in Japanese]. Nippon Yakurigaku Zasshi. 1988;92(1):17-27.

  13. Pozo MA, Balazs EA, Belmonte C. Reduction of sensory responses to passive movements of inflamed knee joints by hylan, a hyaluronan derivative. Exp Brain Res. 1997;116:3-9.

  14. HYALGAN®. [package insert]. Abano Terme, Italy: Fidia Farmaceutici; May 2014

  15. Neustadt DH. Long-term efficacy and safety of intra-articular sodium hyaluronate (HYALGAN®) in patients with osteoarthritis of the knee. Clin Exp Rheumatol. 2003;21(3):307-311.

  16. Stitik TP et al. Arch Phys Med Rehabil. 2007;88(2):135-141

  17. Turajane T, Labpiboonpong V, Maungsiri S. Cost analysis of intraarticular sodium hyaluronate treatment in knee osteoarthritis patients who failed conservative treatment. J Med Assoc Thai. 2007;90(9):1839-1844.

  18. Parmet S, Lynm C, Glass RM. Osteoarthritis of the knee. JAMA. 2003;289(8):1068.

Source: https://hyalgan.com/patients/why-hyalgan/benefits-of-hyalgan/

Knee Injection: Background, Indications, Contraindications

How Hyalgan Is Used to Treat Knee Osteoarthritis

  1. Boon AJ, Smith J, Dahm DL, Sorenson EJ, Larson DR, Fitz-Gibbon PD, et al. Efficacy of intra-articular botulinum toxin type A in painful knee osteoarthritis: a pilot study. PM R. 2010 Apr. 2 (4):268-76. [Medline].

  2. Wang-Saegusa A, Cugat R, Ares O, Seijas R, Cuscó X, Garcia-Balletbó M. Infiltration of plasma rich in growth factors for osteoarthritis of the knee short-term effects on function and quality of life. Arch Orthop Trauma Surg. 2011 Mar. 131 (3):311-7. [Medline].

  3. Sampson S, Reed M, Silvers H, Meng M, Mandelbaum B. Injection of platelet-rich plasma in patients with primary and secondary knee osteoarthritis: a pilot study. Am J Phys Med Rehabil. 2010 Dec. 89 (12):961-9. [Medline].

  4. Chou CL, Lee SH, Lu SY, Tsai KL, Ho CY, Lai HC. Therapeutic effects of intra-articular botulinum neurotoxin in advanced knee osteoarthritis. J Chin Med Assoc. 2010 Nov. 73 (11):573-80. [Medline].

  5. Conti F, Priori R, Chimenti MS, Coari G, Annovazzi A, Valesini G, et al. Successful treatment with intraarticular infliximab for resistant knee monarthritis in a patient with spondylarthropathy: a role for scintigraphy with 99mTc-infliximab. Arthritis Rheum. 2005 Apr. 52 (4):1224-6. [Medline].

  6. Hinton R, Moody RL, Davis AW, Thomas SF. Osteoarthritis: diagnosis and therapeutic considerations. Am Fam Physician. 2002 Mar 1. 65 (5):841-8. [Medline].

  7. Ward EE, Jacobson JA, Fessell DP, Hayes CW, van Holsbeeck M. Sonographic detection of Baker's cysts: comparison with MR imaging. AJR Am J Roentgenol. 2001 Feb. 176 (2):373-80. [Medline].

  8. Schumacher HR Jr. Aspiration and injection therapies for joints. Arthritis Rheum. 2003 Jun 15. 49 (3):413-20. [Medline].

  9. Schumacher HR, Chen LX. Injectable corticosteroids in treatment of arthritis of the knee. Am J Med. 2005 Nov. 118 (11):1208-14. [Medline].

  10. Bellamy N, Campbell J, Robinson V, Gee T, Bourne R, Wells G. Intraarticular corticosteroid for treatment of osteoarthritis of the knee. Cochrane Database Syst Rev. 2006 Apr 19. CD005328. [Medline].

  11. Eder L, Chandran V, Ueng J, Bhella S, Lee KA, Rahman P, et al. Predictors of response to intra-articular steroid injection in psoriatic arthritis. Rheumatology (Oxford). 2010 Jul. 49 (7):1367-73. [Medline].

  12. McMahon AM, Tattersall R. Diagnosing juvenile idiopathic arthritis. Paediatrics and Child Health. 2011. 21:12:552-557.

  13. Aletaha D, Neogi T, Silman AJ, Funovits J, Felson DT, Bingham CO 3rd, et al. 2010 Rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Arthritis Rheum. 2010 Sep. 62 (9):2569-81. [Medline].

  14. Eggebeen AT. Gout: an update. Am Fam Physician. 2007 Sep 15. 76 (6):801-8. [Medline].

  15. [Guideline] Ringold S, Angeles-Han ST, Beukelman T, Lovell D, Cuello CA, Becker ML, et al. 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Treatment of Juvenile Idiopathic Arthritis: Therapeutic Approaches for Non-Systemic Polyarthritis, Sacroiliitis, and Enthesitis. Arthritis Rheumatol. 2019 Jun. 71 (6):846-863. [Medline]. [Full Text].

  16. McAlindon TE, LaValley MP, Harvey WF, Price LL, Driban JB, Zhang M, et al. Effect of Intra-articular Triamcinolone vs Saline on Knee Cartilage Volume and Pain in Patients With Knee Osteoarthritis: A Randomized Clinical Trial. JAMA. 2017 May 16. 317 (19):1967-1975. [Medline].

  17. Briem K, Axe MJ, Snyder-Mackler L. Functional and perceived response to intra-articular hyaluronan injection in patients with knee osteoarthritis: persistence of treatment effects over 5 months. Knee Surg Sports Traumatol Arthrosc. 2009 Jul. 17(7):763-9. [Medline].

  18. Akeda K, An HS, Okuma M, Attawia M, Miyamoto K, Thonar EJ, et al. Platelet-rich plasma stimulates porcine articular chondrocyte proliferation and matrix biosynthesis. Osteoarthritis Cartilage. 2006 Dec. 14(12):1272-80. [Medline].

  19. Kon E, Mandelbaum B, Buda R, Filardo G, Delcogliano M, Timoncini A, et al. Platelet-rich plasma intra-articular injection versus hyaluronic acid viscosupplementation as treatments for cartilage pathology: from early degeneration to osteoarthritis. Arthroscopy. 2011 Nov. 27(11):1490-501. [Medline].

  20. Lockman LE. Practice tips. Knee joint injections and aspirations: the triangle technique. Can Fam Physician. 2006 Nov. 52(11):1403-4. [Medline].

  21. Richette P, Chevalier X, Ea HK, Eymard F, Henrotin Y, Ornetti P, et al. Hyaluronan for knee osteoarthritis: an updated meta-analysis of trials with low risk of bias. RMD Open. 2015. 1 (1):e000071. [Medline].

  22. Jüni P, Hari R, Rutjes AW, Fischer R, Silletta MG, Reichenbach S, et al. Intra-articular corticosteroid for knee osteoarthritis. Cochrane Database Syst Rev. 2015 Oct 22. 10:CD005328. [Medline].

  23. Meheux CJ, McCulloch PC, Lintner DM, Varner KE, Harris JD. Efficacy of Intra-articular Platelet-Rich Plasma Injections in Knee Osteoarthritis: A Systematic Review. Arthroscopy. 2016 Mar. 32 (3):495-505. [Medline].

  24. Filardo G, Kon E, Pereira Ruiz MT, Vaccaro F, Guitaldi R, Di Martino A, et al. Platelet-rich plasma intra-articular injections for cartilage degeneration and osteoarthritis: single- versus double-spinning approach. Knee Surg Sports Traumatol Arthrosc. 2012 Oct. 20 (10):2082-91. [Medline].

  25. Mazzocca AD, McCarthy MB, Chowaniec DM, Cote MP, Romeo AA, Bradley JP, et al. Platelet-rich plasma differs according to preparation method and human variability. J Bone Joint Surg Am. 2012 Feb 15. 94(4):308-16. [Medline].

  26. Rifat SF, Moeller JL. Site-specific techniques of joint injection. Useful additions to your treatment repertoire. Postgrad Med. 2001 Mar. 109(3):123-6, 129-30, 135-6. [Medline].

  27. Rifat SF, Moeller JL. Basics of joint injection. General techniques and tips for safe, effective use. Postgrad Med. 2001 Jan. 109(1):157-60, 165-6. [Medline].

  28. McNeil JD. Intra-articular hyaluronic acid preparations for use in the treatment of osteoarthritis. Int J Evid Based Healthc. 2011 Sep. 9(3):261-4. [Medline].

Source: https://emedicine.medscape.com/article/1997643-overview

Hyalgan Treatment of Osteoarthritis in Post-Operative Knee Arthroplasty Patients

How Hyalgan Is Used to Treat Knee Osteoarthritis

Institutional Review Board, Hospital for Special Surgery

July 06, 2005

The safety of study participants is our top priority. The trial is approved and periodically reviewed by an Institutional Review Board (IRB), which includes doctors, administrators, ethicists, and members of the general public. The safety of clinical trials is reviewed by the U.S. Food and Drug Administration.

Before enrolling in a clinical trial, the investigator will explain the purpose of the trial, its expected benefits, any possible risks or side effects, and what your role will be. This is the time to ask questions! If you want to join the trial, you must sign the informed consent documents. You can leave a clinical trial at any time without penalty.

For further information, see Understanding Clinical Trials.

Geoffrey Westrich, MD

Sarah Schaefer

Approximately 80 patients with osteoarthritis (OA), who have been indicated for knee arthroscopy surgery, will be screened for postoperative knee osteoarthritis treatment. Ideally, 60 patients will be enrolled in the study, however, a 20% dropout rate is being incorporated, resulting in approximately 50 patients completing the study.

After surgery, the study group will receive a series of Hyalgan® injections whereas the control group will not receive any injection. Both groups of patients will have their progress evaluated through radiographs at their 3 months postoperative visit and will be followed up to 6 months following there surgery.

Inclusion Criteria

  1. Knee arthroscopy: débridement
  2. Primary Osteoarthritis
    Clinical involvement of medial compartment (Grade 3 or 4), found prior to surgery through radiographs/MRI's or found during surgery:
    • meniscal pathology
    • chondromalacia patellae
  3. Age: 40 year or older
  4. Active disease (pain & disability) the signal joint: range of motion, visual analog scale (VAS) for pain, performance

Exclusion Criteria

  1. Pregnancy or breast feeding
  2. Failure to meet minimum criteria of the signal joint: range of motion, VAS pain, performance, etc.
  3. Patients with rheumatoid arthritis, a seronegative spondyloarthropathy or other underlying rheumatic condition that could be affecting the subject's knees.
  4. Patients with a current skin infection overlying the proposed injection site
  5. Patients with a history of allergy to avian products, hyaluronan or any study material
  6. Patients with concomitant diseases
  7. Patients undergoing anticoagulant therapy treatment

Principal InvestigatorGeoffrey Westrich, MDHospital for Special Surgery535 East 70th Street, Rm. 324New York, NY 10021Tel: 212.606.1510Fax: 212.639.9266

Email: westrichg@hss.edu

Source: https://www.hss.edu/clinical-trials_hyalgan-treatment-osteoarthritis-knee-arthroplasty-patients.asp

Hyalgan (injection) Uses, Side Effects & Warnings – Drugs.com

How Hyalgan Is Used to Treat Knee Osteoarthritis

Generic Name: sodium hyaluronate (injection) (SO dee um HYE al yoo RON ate)
Brand Name:Durolane, Euflexxa, Gel-One, Gelsyn-3, Hyalgan, Supartz

Medically reviewed by Drugs.com on Mar 17, 2020 – Written by Cerner Multum

What is Hyalgan?

Hyalgan is similar to the fluid that surrounds the joints in your body. This fluid acts as a lubricant and shock absorber for the joints.

Hyalgan is used to treat knee pain caused by osteoarthritis.

Hyalgan is usually given when other arthritis medications have not been effective.

Hyalgan may also be used for purposes not listed in this medication guide.

You should not receive a Hyalgan if you have an infection in your knee or in the skin around your knee.

You should not receive Hyalgan if you are allergic to it, or if you have an infection in your knee or in the skin around your knee.

Hyalgan is not approved for use by anyone younger than 21 years old.

Tell your doctor if you have ever had:

  • blood clots or circulation problems in your legs; or

  • an allergy to birds, feathers, or egg products.

It is not known whether Hyalgan will harm an unborn baby. Tell your doctor if you are pregnant.

It may not be safe to breast-feed a baby while you are using this medicine. Ask your doctor about any risks.

Hyalgan is injected directly into your knee joint. A healthcare provider will give you this injection.

Hyalgan is usually given once every week for 3 to 5 weeks. Follow your doctor's dosing instructions very carefully.

To prevent pain and swelling, your doctor may recommend resting your knee or applying ice for a short time after your injection.

Read all patient information, medication guides, and instruction sheets provided to you. Ask your doctor or pharmacist if you have any questions.

Tell your doctor if your symptoms do not improve, or if they get worse.

Call your doctor for instructions if you miss an appointment for your Hyalgan.

Since this medication is given by a healthcare professional in a medical setting, an overdose is unly to occur.

For at least 48 hours after your injection, avoid jogging, strenuous activity, or high-impact sports such as soccer or tennis. Also avoid weight-bearing activity or standing for longer than 1 hour at a time. Ask your doctor how long to wait before you resume these activities.

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • severe pain or swelling around the knee after the injection.

Common side effects may include:

  • warmth, pain, redness, stiffness, bruising, or puffiness where the medicine was injected;

  • nausea, stomach pain;

  • trouble walking;

  • swelling in your hands or feet;

  • back pain, joint pain, muscle pain;

  • numbness or tingly feeling;

  • headache, dizziness; or

  • runny or stuffy nose, sneezing, sore throat.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Other drugs may affect Hyalgan, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your current medicines and any medicine you start or stop using.

  • Your doctor can provide more information about Hyalgan.

Remember, keep this and all other medicines the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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Source: https://www.drugs.com/mtm/hyalgan-injection.html