Introduction Hyaluron
Where two bones articulate, the surface is covered with cartilidge. Its acts as a shock absorber and as a lubricant providing smooth
and pain-free movements. Arthritis which effects a large percentage of the population is a degenerative joint disease. The wear of the joint cartilage will eventually lead to painfull Bone to Bone contact. Also Osteo
Arthrites and Rhemautoid Arthritis may lead to wear or dissapearance of the cartilage.
Another treatment against Arthritis can be the injection of Hyaluron Acid. Hyaluron is found in the human joint as a a lubricant.
By injecting Hyaluron the joint gets a new surface of a gel-like layer. This method can be compared to the situation where a tire is replaced on a wheel. Some studies show benefit to patients with immediate pain relief. Periods of upto 3 to 4 years have been reported where
patients were free of pain. Studies have shown that Hyaluron can be
injected safely, easy and effectively. The same studies indicate that 5 weekly injections with Hyaluron in the knee joint may be efective against pain in the joint as a result of arthritis.
The physician injects the knee joint with Hyaluron (20 mg/ 2.0 ml), once per week for the duration of 5 weeks (5 injections in total).
The objective of Hyaluron is pain relief. Pain relief may be experienced before the treatment of 5 weeks are over. Studies, however show that
in the majority of the cases, pain relief is fully encountered after the treatment of 5 weeks. The relief sensations may vary from patient to
patient. It is advised not to perform activities such as jogging, tennis, weighing and lifting in the 48 hours following the injections.
Patients should take notice that treatment with Hyaluron may not be succesful with every patient.
Injections with Hyaluron should be avoided in case of skin diseases or infections in the near area of the knee joint. The product should also
not be used if there are allergy reactions to Hyaluron products.
Hynoval®, Hyaluron
Inject Hynoval® for a total of 3-5 times at weekly intervals into the affected joint. Several joints may be treated concurrently. Depending on the severity of the joint disease, the effect of a treatment with five injections may last longer than six months. Repeat treatment regimens are possible. If joint effusion occurs, puncture of the effusion, immobilisation of the joint, application of an ice pack and/or intraarticular
administration of corticosteroids are recommended. Resume treatment with HYNOVAL® after two or three days.
The content is sterile provided the pen is not damaged. Remove the pen from the package, insert it into the applicator, and prepare an
appropriate cannule (e.g. 19 or 21 G).
Pharmacodynamic and pharmacokinetic properties
Joint lubricant, which is retained viscoelastically because of its hyaluronic acid content, is formed in all synovial joints, especially in the large, weight-bearing joints where it ensures normal pain-free movement through its lubricatory and shock-absorbing properties. It is also responsible for supplying the joint cartilage with nutrients.
In degenerative joint diseases such as osteoarthritis, the viscoelasticity of the joint lubricant is significantly compromised, which lessens its
lubricatory and shock-absorbing effect. The mechanical stress on the joint and the destruction of the joint cartilage increase to such an extent that pain and limited mobility occur in the affected joint. Qualitative improvement of the joint lubricant through intra-articular administration of HYNOVAL®, which contains highly purified hyaluronic acid without chicken eggwhite ingredients, can enhance the viscoelastic properties of the joint lubricant. This improves its lubricatory and shock-absorbing
effect and lessens mechanical overloading of the joint. The result is usually alleviation of the pain and improved joint mobility, which can last
for several months after a treatment cycle of five intra-articular injections.
Pharmaceutical forms and package sizes
Introductory package contents:
1 applicator (high quality)
5 pens of sterile HYNOVAL® 20 mg/2.0 mL
5 cannules (19 G or 21 G, sterile)
Refill packages:
5 pens of sterile HYNOVAL® in blister pack
