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Synvisc vs Orthovisc
Introduction
For patients with osteoarthritis or other types of joint disorders, certain treatments can help in reducing pain and improving mobility. Synvisc and Orthovisc are two such treatments that are often prescribed for these conditions. They each have a different composition but both aim to supplement the joint fluid, thereby enhancing functionality and decreasing discomfort in affected joints. Synvisc is comprised of hylan polymers derived from rooster combs while Orthovisc is composed of high molecular weight hyaluronic acid produced through bacterial cells. Both drugs work by mimicking the natural synovial fluid found within joints, helping to lubricate and cushion the area during movement.
What is Synvisc?
Synvisc and Orthovisc are both hyaluronic acid-based viscosupplements, which constitute a significant advancement from the initial class of corticosteroid injections used for osteoarthritis treatment. The FDA first approved Synvisc in 1997, followed by Orthovisc in 2004. These treatments increase levels of hyaluronic acid in arthritic joints by injecting it directly into the joint space, effectively boosting its presence and acting as a lubricant and shock absorber to facilitate smoother joint movement. They are prescribed primarily for knee osteoarthritis when other non-surgical treatments have failed. Both Synvisc and Orthovisc exhibit selective influence on the viscosity within the synovial fluid with minor systemic effects, resulting in fewer side effects compared to corticosteroids that have broader systemic influences.
What conditions is Synvisc approved to treat?
Synvisc and Orthovisc are approved for the treatment of pain associated with osteoarthritis:
- Synvisc is typically used when other non-pharmacologic and pharmacologic treatments like exercise, physical therapy, or simple analgesics have failed to provide relief. It's injected directly into the affected knee joint.
- Orthovisc is also an injectable treatment. It's indicated as a supplement to the synovial fluid in your knee joint to help lubricate it, alleviate pain and improve mobility. This option might be chosen if NSAIDs (nonsteroidal anti-inflammatory drugs) or other medications aren't delivering sufficient relief from symptoms.
How does Synvisc help with these illnesses?
Synvisc and Orthovisc are both treatments for osteoarthritis, a condition characterized by the breakdown of joint cartilage which can cause pain, swelling, and reduced motion. These treatments work to replenish the hyaluronic acid in joints - a naturally occurring substance that provides lubrication and cushioning. Synvisc is made from a combination of cross-linked hyaluronan derived from chicken combs, while Orthovisc is composed of ultra-pure hyaluronan produced through bacterial fermentation. Both substances act as viscosupplements - they increase the viscosity of synovial fluid in affected joints thus improving joint mechanics and reducing pain.
While there isn't necessarily an exact correlation between these two medications like Prozac increases serotonin levels in managing depression, both Synvisc and Orthovisc similarly help manage osteoarthritis symptoms by enhancing natural properties within our bodies (hyaluronic acid) to alleviate discomfort associated with arthritic conditions.
What is Orthovisc?
Orthovisc is a brand name for high molecular weight hyaluronan, which is used as a viscosupplement, increasing the viscosity of synovial fluid in osteoarthritic joints. By doing so, it helps to lubricate, cushion and reduce pain in the joint. It was first approved by the FDA in 2004. Orthovisc differs from Synvisc (another type of hyaluronan) mainly due to its method of administration: typically delivered via three injections over several weeks compared to Synvisc's single injection treatment option. The less concentrated formulation means that Orthovisc causes fewer allergic reactions and side effects such as local swelling or discomfort at the injection site than other injectable treatments like Synvisc. This makes Orthovisc an excellent choice for patients who require long-term management of their knee osteoarthritis symptoms but are concerned about potential adverse reactions.
What conditions is Orthovisc approved to treat?
Orthovisc is a treatment approved for use in individuals suffering from osteoarthritis, specifically:
- Osteoarthritis of the knee
- It's especially useful for those who have not responded adequately to conservative non-pharmacologic therapy or to simple analgesics.
How does Orthovisc help with these illnesses?
Orthovisc is a high molecular weight hyaluronan preparation used to treat osteoarthritis of the knee. It functions by increasing synovial fluid elasticity, viscosity and volume, which provides lubrication and shock absorption in the joint, thereby reducing pain and improving mobility. Similar to Synvisc, Orthovisc works by providing supplemental hyaluronic acid into the joint space but it has a slightly thinner consistency which may make injections easier. Its effects on mitigating symptoms are often noticeable within several weeks after administration. However, unlike Synvisc that typically requires three weekly injections for optimal results, Orthovisc protocol can involve either three or four weekly injections based on patient's need or doctor's discretion. This flexibility could offer an advantage when considering treatment options for osteoarthritis of the knee.
How effective are both Synvisc and Orthovisc?
Both Synvisc (hylan GF 20) and Orthovisc (high molecular weight hyaluronan) are widely used viscosupplement injections developed to treat knee osteoarthritis, providing relief for patients where other treatments may have failed. They were approved by the FDA within a few years of each other, with Synvisc gaining approval in 1997 and Orthovisc following in 2004. Both drugs work by mimicking the body's own synovial fluid to help lubricate and cushion the joint, thereby reducing pain and improving function.
A double-blind clinical trial conducted in 2002 compared Synvisc directly with Orthovisc[1], demonstrating that both treatments resulted in similar levels of pain reduction up to six months post-treatment. In this study, there was no significant difference between patients receiving either treatment when measuring efficacy using WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index), SF-36 Health Survey scores or patient global assessment scores.
However, a systematic review published in The Cochrane Library[2] concluded that while overall evidence suggests these viscosupplements can reduce pain symptoms associated with osteoarthritis at least moderately effectively over controls; it is not yet clear whether one product offers benefits over another considering factors such as injection frequency or side effects profile.
Looking into specific side-effects profiles of both medications reveals some differences: For instance, some studies suggest an increased risk of local reactions with Synvisc than with orthovisc [3]. However more research needs to be done on this aspect due to lack of comparative trials studying adverse events specifically.
In conclusion although both Synvisc and Orthovisc have shown effectiveness as third-line interventions for knee arthritis - meaning they are usually considered after inadequate response or inability to tolerate first line measures like lifestyle modifications NSAIDS etc., choice between these two would depend upon individual patient preferences including cost considerations potential side effects etc.
References:
- https://pubmed.ncbi.nlm.nih.gov/12439230/
- https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD005321.pub4/full
- https://pubmed.ncbi.nlm.nih.gov/25492012/
At what dose is Synvisc typically prescribed?
Injection dosages of Synvisc typically consist of a total of three injections administered one week apart. However, the Synvisc-One formulation allows for a single injection. Studies have suggested that this treatment regimen is effective for managing osteoarthritis knee pain in most patients. For Orthovisc, the standard procedure involves receiving four injections one week apart. In both cases, if there's no improvement observed after completing the initial series of injections, further evaluation and alternative treatments may be considered by your healthcare provider. The maximum dosage should not exceed these specified regimens unless under explicit medical advice.
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At what dose is Orthovisc typically prescribed?
Orthovisc treatment for osteoarthritis knee pain generally starts with one injection per week, for a total of three or four weeks. The injections are administered directly into the knee joint and should be spaced about seven days apart to maintain consistent relief from symptoms. If there is no significant reduction in discomfort after this initial series of treatments, your doctor may decide to administer additional doses. It's important not to exceed more than one injection per week and it's critical that all treatment decisions are made under the guidance of a healthcare professional experienced in intra-articular injections.
What are the most common side effects for Synvisc?
Common side effects of Synvisc and Orthovisc are similar, as both drugs are used to treat osteoarthritis knee pain. These side effects include:
- Pain at the injection site
- Swelling or fluid accumulation in the knee
- Heat sensation in the injected knee
- Rash or hives around the injection area
- Itching skin around injected area
- Fast heartbeat
In rare cases, patients may experience more severe reactions that require immediate medical attention such as difficulty breathing, swelling of face or throat, dizziness and fainting.
It's important to note that these medications should be administered by a healthcare professional who is equipped to handle any potential allergic reaction. Also remember that these lists do not include all possible side effects; always consult your doctor if you have concerns about how you're reacting to treatment.
Are there any potential serious side effects for Synvisc?
While both Synvisc and Orthovisc are hyaluronic acid-based injections used to treat osteoarthritis, they may have slightly different side effects:
- Severe pain or swelling around the injected knee
- Signs of allergic reactions: hives, severe itching, redness or discomfort at the injection site
- Trouble breathing or swallowing
- Dizziness or fainting spells; feeling like you might pass out
- Fast heartbeat, chest tightness
- Infection symptoms such as fever and chills
Furthermore, there can be less common but more serious side effects like bleeding or bruising easily. If you experience any of these symptoms after receiving either Synvisc or Orthovisc injections, seek immediate medical attention. Remember that not all patients will experience these side effects; some people may not notice any adverse reaction at all.
What are the most common side effects for Orthovisc?
Orthovisc could possibly result in the following side effects:
- Joint pain or swelling at injection site
- Mild nausea
- Muscle stiffness or pain
- Headache, dizziness
- Mild skin itching
- Temporary increase in joint inflammation and pain after the injection (post-injection flare)
It is essential to note that these effects are usually mild and temporary. However, if any of these symptoms persist or worsen, it's important to seek immediate medical attention.
Are there any potential serious side effects for Orthovisc?
Though Orthovisc is generally well-tolerated, some individuals may experience adverse reactions. The following are potential symptoms of a serious reaction to Orthovisc:
- Signs of an allergic reaction such as hives; difficulty breathing; swelling of your face, lips, tongue or throat.
- Severe pain or trouble moving your treated knee.
- Swelling in your knee or leg that doesn't go away.
- Fever and chills which could indicate infection.
- Bleeding or severe bruising around the injection site.
These side effects are not common but if you experience any of them after receiving an Orthovisc injection, it's important to seek medical attention promptly.
Contraindications for Synvisc and Orthovisc?
Both Synvisc and Orthovisc are viscosupplements used to treat osteoarthritis of the knee, but they may cause some side effects in certain patients. If you experience severe pain or swelling after an injection, contact your doctor immediately.
Neither Synvisc nor Orthovisc should be used if you have a known allergy to hyaluronate preparations or bird proteins, feathers, or egg products since these medications are derived from them. Always inform your physician about any allergies; an allergic reaction will require immediate medical attention and cessation of medication to prevent serious complications.
These injections can lead to temporary inflammation in the treated knee. Additionally, they should not be used by individuals with skin diseases or infections at the site of injection as it can increase risk for localized infection and inflammation.
Synvisc and Orthovisc do not interact with other drugs taken orally or injected; however, always tell your healthcare provider about all other medications you use including prescription drugs, over-the-counter medicines as well as vitamins and herbal supplements.
How much do Synvisc and Orthovisc cost?
For the brand name versions of these injectable medications:
- The price for a single 6 ml injection of Synvisc-One (hylan G-F 20) averages around $750, which is typically administered once every six months. This translates to approximately $4/day.
- Orthovisc (high molecular weight hyaluronan), on the other hand, requires multiple injections with each dose costing about $210-$250. A standard treatment course usually involves three or four injections over several weeks, equating to roughly $2-$3 per day.
Therefore, if you are receiving full courses of treatment from both brands, then Orthovisc may be less expensive on a per-day basis than Synvisc-One. Keep in mind that cost should not be your only consideration when determining which drug is right for you; effectiveness and patient comfort also matter greatly.
As far as generic options go, neither medication has a direct equivalent due to their unique formulations and approval processes - they are considered medical devices rather than typical pharmaceuticals.
Popularity of Synvisc and Orthovisc
Hylan G-F 20, also known by the brand name Synvisc, is a type of hyaluronic acid injection used for osteoarthritis knee pain when other treatments have been ineffective. In 2020, about 1.5 million people in the US received prescriptions for Synvisc. These injections accounted for around 28% of all hyaluronic acid injections prescribed that year.
Orthovisc, another form of hyaluronic acid injection with similar indications and usage to Synvisc, was prescribed to approximately one million people in the same year. This accounted for just under 19% of all such prescriptions in the United States during this time frame.
Both medications are not typically first-line treatments but can provide effective relief from osteoarthritis pain when initial options fail or cannot be used due to patient-specific factors. The choice between these two may come down to individual factors such as medical history and personal preference after discussing potential benefits and risks with a healthcare provider.
Conclusion
Both Synvisc (hylan G-F 20) and Orthovisc (high molecular weight hyaluronan) are injectable viscosupplements used to treat the symptoms of osteoarthritis, particularly in patients who have not responded adequately to conservative non-pharmacologic therapy or simple analgesics. They work by mimicking natural synovial fluid and enhancing joint lubrication, thereby reducing pain and improving function.
While they share a similar mechanism of action, there are differences between them. For instance, Synvisc is typically administered as three injections given one week apart while Orthovisc is often prescribed as four injections with a gap of one week between each injection.
The choice between these two treatments will depend on patient-specific factors such as severity of symptoms, previous response to treatment and individual tolerance for the procedure. Both agents may cause side effects including local reactions like swelling or redness at the injection site but usually these effects are mild and transient.
Both drugs may require an adjustment period after administration before noticeable alleviation in joint pain occurs. Patients should be closely monitored during this period for any adverse reactions or worsening symptoms that may necessitate medical attention.
Synvisc has been available longer than Orthovisc giving it more long-term safety data. However both products are generally well-tolerated when used appropriately under specialist supervision.
It's important for patients considering either drug to discuss thoroughly with their healthcare provider about potential benefits versus risks so they can make an informed decision based on their specific clinical situation.