NEWTOWN SQUARE, Pa., Nov. 18 A panel of osteoarthritis (OA) key opinion leaders has developed a consensus of the optimal exogenous hyaluronic acid (HA) treatment. This consensus was achieved by utilizing what the experts referred to as BioRestorative(TM) Profiling. This profiling examines HAs on the basis of their mimicking the body's natural HA. "BioRestorative(TM)" describes the features of the ideal HA product, based on the treatment goals of symptom relief, improvement in function, and improved quality of life. In a comparison of available HA products, EUFLEXXA® (1% sodium hyaluronate) best matched the BioRestorative profile. Results of the panel's discussion were published in an independent educational publication authored by members of The Institute for Clinical Care, accessible at www.clincare.org. The report was sponsored by Ferring Pharmaceuticals Inc., the maker of EUFLEXXA®, and published by Dardine & Associates, LLC.
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Features of the Ideal HA Product
The panel hypothesized that the exogenous HA product likely to yield the best results in OA treatment is one that most closely resembles endogenous human HA in all ways, including size, structure and molecular weight. The ideal HA would have high viscosity and high molecular weight. When injected, it would supplement the synovial fluid inside the knee and lubricate and protect the joint. The product would also be as pure as possible, containing no contaminants or animal proteins. A low protein concentration lowers the risk of inflammatory reactions and pseudosepsis.
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"The term 'BioRestorative' suggests that an ideal HA has a restorative effect on naturally occurring synovial fluid in the joint," said panel leader Dr. Jeffrey E. Rosen, Chairman, Department of Orthopaedics and Physical Medicine & Rehabilitation at New York Hospital Queens. "Of the currently marketed HA products, non-avian EUFLEXXA® most closely fits the BioRestorative profile. It has ultra-high purity, high molecular weight, and minimal protein content."
About HA Treatment
In the joint, HA is essential to water balance, viscosity, lubrication and the structure of cartilage. It provides a cushion to protect the inside of the joint from mechanical damage and acts as a shock-absorbing fluid and regulator of water and metabolites. In synovial fluid, HA binds to other molecules, helping it withstand weight-bearing force and movement of the joint. Injections into the joint have been shown to provide long-term improvement of the quantitative and qualitative properties of endogenous HA, increasing joint lubrication and reducing pain.(1) Most current products are avian-derived, and two are bioengineered via fermentation of bacteria.
About The Institute for Clinical Care
The Institute for Clinical Care was established in 2005 to facilitate the development and dissemination of timely and clinically relevant educational programming sponsored by respected institutional and nonprofit providers of continuing education for healthcare providers. The clinical authorities with whom the Institute works are recognized leaders in their field. It is under their direction and with their contribution and approval that the content for the Institute's educational offerings are developed.
(1) Hempfling H. Intra-articular hyaluronic acid after knee arthroscopy: a two-year study. Knee Surg Sports Traumatol Arthrosc. 2007;14(3):537-546.
SOURCE The Institute for Clinical Care
