Viscosupplements
Viscosupplement medication involves supplementing the diminished amount of hyaluronic acid in the diseased joint’s degraded synovial fluid with a hyaluronic acid product that possesses the rheological properties of healthy synovial fluid.
These medications are normally offered as second-line therapies, which are treatments that are used after the patient has not adequately responded to primary treatments such as pain medication and physical therapy. Viscosupplement preparations differ significantly in their molecular weight, concentration, rheological properties, manufacturing processes, and residence times in the joint.
The effects that viscosupplements confer are delayed but long-lasting. While it can sometimes take weeks or even several months for the full results of viscosupplements like Orthovisc injectables and Synvisc to materialize, these medications can provide up to six months of improvement, including reduced pain and a greater range of motion.
As a pharmaceutical class, viscosupplements have been widely studied and consistently shown to be safe and effective for the treatment of knee osteoarthritis. They are widely used and accepted by many doctors and medical practitioners.
Knee Osteoarthritis and Hyaluronic Acid
Osteoarthritis of the knee is a painful degenerative condition of the knee joint in which the gradual breakdown of the protective cartilage around the ends of the bones leads to damage and the gradual destruction of the joint, causing symptoms of inflammation, stiffness, and pain.
Patients with this disease suffer from limited mobility that often interferes with daily activities. Typical strategies to cope with this progressive, degenerative disease include the use of analgesics, physical therapy, and weight loss management, or a combination of the above.
A critical component in the development of osteoarthritis is synovial fluid, the thick, viscous liquid found in synovial joints like the knees that is responsible for the lubrication and cushioning of the bones. Synovial fluid is primarily made up of hyaluronic acid, which provides synovial fluid with its highly viscoelastic properties.
In people with knee osteoarthritis, the quantity and size of the hyaluronic acid molecules in the synovial fluid is reduced, resulting in rheological changes to the fluid itself. The fluid becomes thinner and more watery, reducing its ability to lubricate and cushion the joint.
Orthovisc vs. Synvisc
• Composition: Synvisc is made of a complex of reticulated hylan, hylan A and hylan B. Hylan A is a soluble, high-molecular-weight molecule that comprises 80% of the complex, while hylan B is an insoluble gel-like continuous molecular network that makes up the remaining 20% of the complex. Orthovisc, on the other hand, comprises cross-linked, high-molecular-weight hyaluronan.
• Viscoelastic properties: Synvisc injection has viscoelastic properties that are more similar to those of the synovial fluid of young and healthy adults. This positively impacts the efficacy of the product’s lubrication and shock-absorption.
• Clinical outcomes: Researchers examined the differences in clinical and cost outcomes among different viscosupplements and found that Synvisc has a reduced effect in respect to delaying knee replacement surgery when compared to other products, including Orthovisc.
• Hyaluronan sources: While Synvisc is made from rooster and chicken combs, the hyaluronic acid used in Orthovisc is derived from bacterial cells. A study by Petrella et al. found evidence suggesting that products with non-avian-derived hyaluronic acid have a lower risk of causing side effects when compared to products with hyaluronic acid derived from avian sources.
• Adverse event profile: Synvisc is associated with greater incidences of acute local reactions, an occurrence that is not seen with treatment using other viscosupplements, including Orthovisc. These reactions seem to increase in frequency with repeated treatments. The incidence of acute local reactions with Synvisc treatment may be attributed to the product’s manufacturing process, which involves using chemical divinyl sulfone and formaldehyde to crosslink the native hyaluronan. These chemicals may provoke an immunological tissue reaction, leading to pseudosepsis.
Conclusion
Hyaluronic acid viscosupplement injections are a safe and efficacious way to help patients treat and manage their knee osteoarthritis symptoms in the long term. While Synvisc and Orthovisc have great results, there are considerable differences regarding their respective adverse event profiles, product composition, and clinical outcomes.
Patients should always consult a knowledgeable medical practitioner when deciding which of these products is the right one for them.
Aesthetic injectable companies refer to businesses or companies that specialize in manufacturing, distributing, or providing aesthetic injectable products and services. These companies focus on developing and supplying injectable substances used for cosmetic purposes, typically administered by qualified medical professionals. Aesthetic injectable companies play a crucial role in the field of aesthetic medicine and cosmetic dermatology by offering a variety of injectable products designed to enhance facial features, reduce wrinkles, and improve overall skin appearance.
Key aspects of aesthetic injectable companies include:
-
Product Development: These companies research, develop, and manufacture aesthetic injectables such as dermal fillers, botulinum toxins (e.g., Botox), collagen stimulators, and other specialized formulations. They often innovate new products to meet evolving market demands and technological advancements.
-
Distribution and Sales: Aesthetic injectable companies distribute their products through authorized channels, including healthcare providers, medical spas, and aesthetic clinics. They may also sell directly to licensed professionals who administer these treatments.
-
Regulatory Compliance: Due to the medical nature of their products, aesthetic injectable companies adhere to strict regulatory guidelines and obtain necessary approvals from health authorities (e.g., FDA in the United States) to ensure safety, efficacy, and quality standards.
-
Training and Support: Many companies provide training and educational support to healthcare professionals on the proper use, administration techniques, and safety protocols associated with their injectable products. This ensures that practitioners can deliver treatments effectively and safely.
-
Customer Support: Aesthetic injectable companies offer customer support services to healthcare providers and consumers, addressing inquiries, providing product information, and assisting with product usage and troubleshooting.
