HYALGAN® is for the treatment of osteoarthritis knee pain, when simple painkillers (like Tylenol® or Advil®) or exercise and physical therapy are not enough. The treatment that's right for you will depend on how far your osteoarthritis has progressed, how much pain you are experiencing, and what has worked (or not worked) for you in the past. HYALGAN® is indicated for the treatment of pain due to osteoarthritis of the knee. Speak to your doctor if HYALGAN® is the right treatment option for you.
Your health care provider will review your medical history and examine your knee to determine if an injection of HYALGAN® may be safely given.
Each patient's response to HYALGAN® may vary, depending on severity of your OA, degree of pain, and pre-existing medical conditions. In some patients, successful treatment may reduce pain within the first week after treatment begins. However, based upon clinical trials, most patients experienced pain relief after their third injection of HYALGAN®. 1
Five injections given at weekly intervals can provide most patients with long-lasting pain relief for up to 6 months. The duration of pain relief you experience may vary.
Some patients may experience benefit with 3 injections given at weekly intervals*. This has been noted in studies of published literature receiving 3 injections who were followed for 60 days.
Everybody responds differently to pain. For some people, HYALGAN® may provide all the osteoarthritis knee pain relief that's needed. Other people may get the greatest pain relief by adding HYALGAN® injections to the nonprescription or prescription medicines they're already taking. HYALGAN® has no known drug interactions, but if you have questions about other medications you may be taking, talk to your health care provider.
Side effects sometimes seen when HYALGAN® is injected into the knee are pain, swelling, heat, and/or redness of the joint, as well as rash, itching, or bruising around the HYALGAN® injection area. These reactions were generally mild and did not last long. 14
Yes. HYALGAN® has been shown to be safe for repeat treatment in a 30-month study. In clinical studies, 1 cycle (5 injections) of HYALGAN® treatment provided pain relief up to 6 months. Because osteoarthritis is a chronic and degenerative condition, you and your health care provider can decide when it's time to repeat the treatment. 9
If you have pain due to osteoarthritis of the knee, there are treatments that do not involve injections of HYALGAN® into the joint.14 These include:
Altman RD, Moskowitz R; HYALGAN® Study Group. Intraarticular sodium hyaluronate (HYALGAN®) in the treatment of patients with osteoarthritis of the knee: a randomized clinical trial. J Rheumatol. 1998;25(11):2203-2212.
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.
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.
HYALGAN®, data on file. Fidia Farmaceutici S.p.A., Italy.
HYALGAN® (sodium hyaluronate), approval letter. Food and Drug Administration Web site. http://www.accessdata.fda.gov/cdrh_docs/pdf/P950027a.pdf. Accessed August 18, 2011.
Carrabba M, Paresce E, Angelini M, Re KA, Torchiana EEM, Perbellini A. The safety and efficacy of different dose schedules of hyaluronic acid in the treatment of painful osteoarthritis of the knee with joint effusion. Eur J Rheumatol Inflamm. 1995;15(1):25-31.
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.
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.
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.
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.
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.
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.
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.
HYALGAN®. [package insert]. Abano Terme, Italy: Fidia Farmaceutici; May 2014
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.
Stitik TP et al. Arch Phys Med Rehabil. 2007;88(2):135-141
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.
Parmet S, Lynm C, Glass RM. Osteoarthritis of the knee. JAMA. 2003;289(8):1068.