A few words about osteoarthritis and the role of hyaluronan in its treatment
Osteoarthritis (OA) is a disease that results in the destruction of all the joint tissues: cartilage, surfaces of the articular bones, bursal sac and its inner covering, or the synovial fluid film, ligaments, and muscles. In mature articular cartilage, chondrocytes are located inside the extracellular matrix (EM), where its mechanical property is to absorb the impact. This ability is determined by the presence of highly organized macromolecular structures, including proteoglycans, collagen type II, and hyaluronic acid. In healthy cartilage tissue, EM synthesis and degradation are balanced among themselves, while in OA, matrix degradation predominates.
EM viscoelastic properties depend on the quantity (concentration) and quality (molecular weight) of hyaluronic acid. In the healthy joint synovial fluid, the proteoglycan monomer has a molecular weight of 3 to 5 MDa. At OA it is significantly lower than normal because the ability of synovial cells to synthesize new EM is impaired, while the ‘aging’ EM progressively degrades (hyaluronic acid is cleaved by hyaluronidase and the completely macromolecular complex is broken apart).
Hyaluronic acid plays a key role in determining the viscoelastic properties of the synovial fluid, maintaining the structure and function of cartilage tissue. Studies have shown that this substance is capable of:
Euflexxa vs. Synvisc composition comparison
Both drugs are based on a solution of sodium hyaluronate in the phosphate-buffered saline. The method of obtaining hyaluronate and, accordingly, the size of its molecule are different. Therefore, in Euflexxa contains a substance extracted from bacteria cells. While Synvisc uses hyaluronate extracted from chicken combs.
In both cases, the active substance is thoroughly purified before use, to minimize the risk of allergic and other undesirable reactions. But it is worth mentioning that Synvisc has a much larger molecule size (6 MDa vs. 2.4—3.6 MDa in Euflexxa). This size is caused by the special structure: hyaluronan derivatives — hylan A (in fluid) and hylan B (in gel) — specifically related (crosslinked) to each other. At the same time, the Euflexxa contains only unmodified sodium hyaluronate.
Synvisc vs. Euflexxa: indications for use
Preparations intended for the treatment of osteoarthritis only of the knee joints and only if non-pharmacological treatment and simple analgesics such as acetaminophen did not produce the expected result.
Euflexxa injections vs. Synvisc treatment and lasting comparison
Both remedies are injected directly into the knee joint. In the Euflexxa case, the treatment includes 3 injections, which are carried out consecutively for 3 weeks. For Synvisc-One, one injection is sufficient, as the syringe contains three doses of simple Synvisc at once.
With regard to the speed and duration effect, the Euflexxa starts to act a little faster, but the effect eventually declines a little faster. The Synvisc has a slightly slower effect, and the decline over time is not so noticeable. These phenomena are caused by the different molecular weight of the active substance, however, according to the studies, the indices of the drugs differ slightly.
The noticeable effect occurs at 4 weeks from the start of treatment and lasts up to 6 months. It should be kept in mind that the specific duration of medication may vary from person to person due to many factors.
Side effects and contraindications
Undesirable manifestations of therapy with these drugs include possible pain in the joint, ligaments and muscles around it, joint swelling. When Synvisc-One is used, redness, heat, and fluid build-up may be added.
Precautions for use of all hyaluronate-containing agents include pregnancy, allergic reactions to drug components, inflammatory processes in the injection site
Euflexxa vs Synvisc cost
Now there is an opportunity easily to buy Synvisc-One or Euflexxa online from almost anywhere in the world. If we compare the cost of these drugs in the United States Euflexxa price varies between $337.99 — $425.00 per 6 ml, Synvisc-One costs from $486 —$644 per 6 ml.