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Science of the SYNVISC® Family


The SYNVISC® family of viscosupplements are specifically designed to mimic healthy, young synovial fluid1-3

Crosslinking provides SYNVISC® and Synvisc-One® with rheological properties similar to healthy, young synovial fluid1-3

   
    Healthy, young
synovial fluid1,2,3
SYNVISC and
Synvisc-One1,2
Osteoarthritic
synovial fluid4,5
   
    Average molecular weight*
(million Daltons)
6 6 1.9    
    Elasticity* (Pa at 2.5 Hz) 117 111 1.9    
    Viscosity* (Pa at 2.5 Hz) 45 25 1.4    
   

*The clinical significance of these physical properties is unknown. No comparative conclusions regarding safety or efficacy should be derived from these data points.

†As in 21- to 45-year-old adults.

‡As in 18- to 27-year-old adults.

Why is crosslinking so important for hyaluronan (HA)?6,7

  • Longer intra-articular residence time
  • Higher molecular weight
  • Increased lubricating property
  • Increased shock-absorbing property

The SYNVISC family has distinct characteristics within the viscosupplement class

SYNVISC®/Synvisc-One® is the highest–molecular-weight, crosslinked HA available1,2,8-18

*The clinical significance of these physical properties is unknown.

Only SYNVISC and Synvisc-One are composed of 2 crosslinked polymers: a fluid (Hylan A) and a gel (Hylan B)21-24*

*The clinical significance of these physical properties is unknown.

The SYNVISC family of viscosupplements are specifically designed with unique viscoelastic properties1,2

*The clinical significance of these physical properties is unknown. This information is not based on any head-to-head clinical trial. No comparative conclusions regarding safety or efficacy should be derived from these data points.

References

  1. SYNVISC (hylan G-F 20) [prescribing information]. Cambridge, MA: Genzyme Corporation; 2014.
  2. Synvisc-One (hylan G-F 20) [prescribing information]. Cambridge, MA: Genzyme Corporation; 2014.
  3. Balazs EA, Watson D, Duff IF, Roseman S. Hyaluronic acid in synovial fluid. I. Molecular parameters of hyaluronic acid in normal and arthritis human fluids. Arthritis Rheum. 1967;10(4):357-376.
  4. Mazzucco D, McKinley G, Scott RD, Spector M. Rheology of joint fluid in total knee arthroplasty patients. J Orthop Res. 2002;20(6):1157-1163.
  5. Watterson JR, Esdaile JM. Viscosupplementation: therapeutic mechanisms and clinical potential in osteoarthritis of the knee. J Am Acad Orthop Surg. 2000;8(5):277-284.
  6. Bhuanantanondh P, Grecov D, Kwok E. Rheological study of viscosupplements and synovial fluid in patients with osteoarthritis. J Med Biol Eng. 2012;32(1):12-16.
  7. Henrotin Y, Raman R, Richette P, et al. Consensus statement on viscosupplementation with hyaluronic acid for the management of osteoarthritis. Semin Arthritis Rheum. 2015;45(2):140-149.
  8. Euflexxa (1% sodium hyaluronate) [prescribing information]. Parsippany, NJ: Ferring Pharmaceuticals; 2016.
  9. Orthovisc (high molecular weight hyaluronanSynvisc-One (1 x 6 mL) ) [prescribing information]. Raynham, MA: DePuy Mitek Inc; 2005.
  10. Monovisc summary of safety and effectiveness data. Silver Spring, MD: US Food and Drug 14,15Administration; 2014.
  11. Hyalgan (sodium hyaluronate) [prescribing information]. Parsippany, NJ: Fidia Pharma USA Inc; 2014.
  12. Supartz FX (sodium hyaluronate) [prescribing information]. Durham, NC: Bioventus LLC; 2015.
  13. Gel-One (cross-linked hyaluronate) [prescribing information]. Warsaw, IN: Zimmer USA; 2011.
  14. Hymovis (high molecular weight viscoelastic hyaluronan) [prescribing information]. Parsippany, NJ: Fidia Pharma USA Inc; 2015.
  15. GenVisc 850 (sodium hyaluronate) [prescribing information]. Doylestown, PA: OrthogenRx Inc; 2015.
  16. Gelsyn-3 (sodium hyaluronate) [prescribing information]. Pambio-Noranco, Switzerland: Institut Biochimique SA; 2016.
  17. Visco-3 (sodium hylauronate) [prescribing information]. Durham, NC: Bioventus LLC, 2016
  18. Durolane [prescribing information]. Durham, NC: Bioventus LLC, 2017
  19. Data on file. Intra-articular Residence Time Calculation. Genzyme Corporation.
  20. Bert JM, Waddell DD. Viscosupplementation with hylan g-f 20 in patients with osteoarthrosis of the knee. Ther Adv Musculoskelet Dis. 2010;2(3):127-132.
  21. Larsen NE, Dursema HD, Pollak CT, Skrabut EM. Clearance kinetics of a hylan-based viscosupplement after intra-articular and intravenous administration in animal models. J Biomed Mater Res B Appl Biomater. 2012;100(2):457-462.
  22. Balazs EA, Leshchiner A, Leshchiner A, Band P, Inventors; Biomatrix Inc, Ridgefield, NJ, assignee. Chemically modified hyaluronic acid preparation and method of recovery thereof from animal tissues. US patent 4,713,448. December 15, 1987.
  23. Balazs EA, Leshchiner A, Inventors; Biomatrix Inc, Ridgefield, NJ, assignee. Cross-linked gels of hyaluronic acid and products containing such gels. US patent 4,582,865. April 15, 1986.
  24. Sanofi. The Making of SYNVISC [video]. 2001.
  25. Gomis A, Pawlak M, Balazs EA, Schmidt RF, Belmonte C. Effects of different molecular weight elastoviscous hyaluronan solutions on articular nociceptive afferents. Arthritis Rheum. 2004;50(1):314-326
  26. Smith MM, Russell AK, Schiavinato A, Little CB. A hexadecylamide derivative of hyaluronan (HYMOVIS®) has superior beneficial effects on human osteoarthritic chondrocytes and synonoviocytes than unmodified hyaluronan. J Inflamm (Lond). 2013;10:26
  27. Finelli I, Chiessi E, Galesso D, Renier D, Paradossi G. A new viscosupplement based on partially hydrophobic hyaluronic acid: a comparative study. Biorheology. 2011;48(5):263-275
  28. Brathwaite GJ, Daley MJ, Toledo-Velasquez D. Rheological and molecular weight comparisons of approved hyaluronic acid products—preliminary standards for establishing class III medical device equivalence. J Biomater Sci Polym Ed. 2016;27(3):235-246

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