Euflexxa (hyaluronic acid) / Ferring - LARVOL DELTA

Diffusion of Affibody molecules in extracellular matrix mimetic hydrogels and the effect of albumin binding. (PubMed, Int J Biol Macromol) - "In this work we investigated the diffusivities (D) of Affibody molecules, with systematically varied molecular design, in solution and within extracellular matrix mimetic hydrogels composed of either agarose or collagen and hyaluronic acid (COL-HA) using fluorescence recovery after photobleaching...In COL-HA gels HSA-binding reduced the effect of electrostatic interactions effectively facilitating the transport of those compounds. In conclusion, molecular design especially inclusion of an ABD affected the transport properties of the tested Affibody molecules."

Journal • Oncology

Diffusion of macromolecules in extracellular matrix mimetic hydrogels - effect of size and charge. (PubMed, Eur J Pharm Sci) - "Hydrogels consisting of either agarose, cross-linked collagen and hyaluronic acid (HA) or cross-linked HA, were made and equilibrated in solutions of FITC-dextrans of varying sizes (4 to 150 kDa) and model peptides of varying net charge (+2 to +9)...The cationic peptides were enriched in the oppositely charged gels and their diffusivities decreased with increasing peptide charge. The experimental results were in semi quantitative agreement with an electrostatic model presented in this work."

Journal

A retrospective claims data analysis of health care utilization and cost among patients receiving multi-injection intraarticular hyaluronic acid. (PubMed, J Manag Care Spec Pharm) - "HMW HA patients had statistically significantly lower adjusted all-cause and KOA-related medical and pharmacy costs at 1 year follow-up compared with MMW HA and LMW HA patients. It is unclear if this is related to differences in molecular weight or specific mechanism of actions."

HEOR • Journal • Retrospective data • Immunology • Orthopedics • Osteoarthritis • Pain • Rheumatology

FRAP analysis of peptide diffusion in extracellular matrix mimetic hydrogels as an in vitro model for subcutaneous injection. (PubMed, Int J Pharm) - "Gels were made consisting of either agarose, cross-linked collagen (COL) and hyaluronic acid (HA) or cross-linked HA. Peptide aggregation could be observed as immobile fractions in experiments with exenatide. We conclude that the FRAP method provides useful information of peptides' interactions and transport properties in hydrogel networks, giving insight into the mechanisms affecting absorption of drug compounds after subcutaneous injection."

Journal • Preclinical

Phase 1b Clinical Trial to Evaluate PEP and EUFLEXXA for Knee Osteoarthritis (KOA) (clinicaltrials.gov) - P1 | N=24 | Not yet recruiting | Sponsor: Rion Inc.

New P1 trial • Immunology • Osteoarthritis • Pain • Rheumatology

Intra-articular Platelet-Rich Plasma Compared With Viscosupplementation in the Treatment of Knee Osteoarthritis (clinicaltrials.gov) - P2 | N=100 | Recruiting | Sponsor: NorthShore University HealthSystem | Unknown status ➔ Recruiting | Trial completion date: Oct 2020 ➔ Dec 2027 | Trial primary completion date: Jun 2020 ➔ Dec 2025

Enrollment open • Trial completion date • Trial primary completion date • Immunology • Osteoarthritis • Pain • Rheumatology • CRP

Health Economic Assessments of Hyaluronic Acid Treatments for Knee Osteoarthritis: A Systematic Review. (PubMed, Adv Ther) - "The available efficacy and safety data as well as health economic analyses on the use of HA for knee OA management suggest that there are economic benefits of this treatment option. From a healthcare system perspective, the body of HA literature summarizes favorable costs profile, decreased opioid and corticosteroid use as rescue medication, and a delay to the need for TKA in patients who have HA included in their treatment regimen."

HEOR • Journal • Review • Immunology • Orthopedics • Osteoarthritis • Pain • Rheumatology

A Comparison of All-Cause and Knee Osteoarthritis (KOA)-Related Costs of Newly-Diagnosed Koa Patients Treated with Multi-Injection IA-HAs: A Retrospective Database Analysis (ISPOR 2023) - "OBJECTIVES: To compare all-cause and knee osteoarthritis (KOA)-related costs associated with procedures and visits of newly-diagnosed KOA patients treated with multi-injection IA-HAs (Intra-articular hyaluronic acid) in real-world practice... KOA patients treated with Euflexxa is associated with statistically significant lower KOA-related costs compared to that of Orthovisc or Hyalgan/Supartz FX. More research on treatment associated cost is warranted to potentially lower cost of patient care."

Retrospective data • Immunology • Osteoarthritis • Pain • Rheumatology

Association Between Bio-Fermentation Derived Hyaluronic Acid and Healthcare Costs Following Knee Arthroplasty. (PubMed, Clinicoecon Outcomes Res) - "Bio-HA use prior to knee arthroplasty did not appear to increase overall healthcare costs in the six months before and after surgery. Allowing access to HA injections provides a non-surgical therapeutic option without increasing cost or risk of post-surgical complications."

HEOR • Journal • Immunology • Infectious Disease • Orthopedics • Osteoarthritis • Pain • Rheumatology

Co-formulations of adalimumab with hyaluronic acid / polyvinylpyrrolidone to combine intraarticular drug delivery and viscosupplementation. (PubMed, Eur J Pharm Biopharm) - "Furthermore, polymer-mediated stabilization of the antibody activity was detected. In summary, hyaluronic acid - polyvinylpyrrolidone combinations can be efficiently used to prolong the residence of adalimumab in the joint cavity while simultaneously supplying viscosupplementation."

Journal

Euflexxa for the Treatment of Osteoarthritis (clinicaltrials.gov) - P=N/A; N=30; Completed; Sponsor: The Cleveland Clinic; Active, not recruiting ➔ Completed

Clinical • Trial completion • Immunology • Osteoarthritis • Pain • Rheumatology • TNFA

Changes in prescription pain medication and intra-articular corticosteroid utilization after intra-articular bio-fermentation derived hyaluronic acid use in patients undergoing multimodal pain management. (PubMed, J Med Econ) - "Total monthly CS injections decreased from 2,292 to 663. Our data suggests that high molecular weight Bio-HA, as part of multimodal therapy, may be effective in providing longer-term pain relief with the reduction in pain therapy (CS injections and opioids) and increase in prescription pain medication-free days."

Clinical • Journal • Immunology • Osteoarthritis • Pain • Rheumatology

A Comprehensive Review of Viscosupplementation in Osteoarthritis of the Knee. (PubMed, Orthop Rev (Pavia)) - "Current treatment options include Hylan g-f-20, Sodium Hyaluronate preparations (Suparts Fx, Euflexxa, Gelsyn-3, Durolane, Hyalgen), single-use agents (Gel-One, Synvisc-One, Monovisc), and Hyaluronan (Orthovisc, Monovisc, Hymovic). VS effectively reduces pain, increases functionality, and delays surgery in the knee to treat osteoarthritis. While previous studies have demonstrated variable results, more evidence is becoming available generally supportive of the benefit of VS in the treatment of knee OA."

Journal • Review • Immunology • Inflammation • Musculoskeletal Pain • Osteoarthritis • Pain • Rheumatology • NFKB1

Risk of Severe Acute Localized Reactions for Different Intraarticular Hyaluronic Acid Knee Injections in a Real-World Setting. (PubMed, Cartilage) - "Case reports of severe acute localized reactions (SALR) following intraarticular (IA) hyaluronic acid (HA) injections for knee osteoarthritis (OA) have been described. Among the single injection products, Hylan G-F 20 (6 mL) single injection had lower rates of SALR than Monovisc and Gel-One. This study shows no clear correlation between avian-derived or cross-linked products and SALR and provides evidence against avian-derived products or crosslinking as a source for these reactions."

Clinical • Journal • Real-world evidence • Immunology • Infectious Disease • Inflammation • Orthopedics • Osteoarthritis • Pain • Rheumatology

Delay to TKA in Patients Treated with a Multimodal Approach Using High Molecular Weight, Biologically Derived Hyaluronic Acid. (PubMed, J Long Term Eff Med Implants) - "These results confirm that treatment of knee OA should consider the use of multimodal therapy instead of focusing on individual treatment options. Additionally, the use of repeated courses of IA-BioHA should be considered for prolonged benefit for patients with symptomatic knee OA."

Clinical • Journal • Orthopedics • Pain

Insights from Real-World Analysis of Treatment Patterns in Patients with Newly Diagnosed Knee Osteoarthritis. (PubMed, Am Health Drug Benefits) - "This retrospective analysis used data from the electronic health records of the Geisinger Health System between January 1, 2010, and December 2018 to identify adults with newly diagnosed knee OA who had not received previous therapy with intra-articular corticosteroids, opioids, intra-articular hyaluronic acid, or prescription nonsteroidal anti-inflammatory drugs (NSAIDs)...Of note, 22.9% of the patients received only 1 evaluated therapy during the study period and did not receive a second treatment. Real-world treatment patterns in patients with newly diagnosed knee OA indicate that prescribers are using the spectrum of the available therapies that, at times, are different from the current treatment guideline recommendations."

Clinical • Journal • Real-world evidence • Immunology • Orthopedics • Osteoarthritis • Pain • Rheumatology

Hyaluronic Acid Increases Anti-Inflammatory Efficacy of Rectal 5-Amino Salicylic Acid Administration in a Murine Colitis Model. (PubMed, Biomol Ther (Seoul)) - "Combined rectal therapy with HA and 5-ASA could be a treatment alternative for severe cases of IBD as it was the only treatment tested that was not significantly different from the healthy control group. This study further underlines the benefit of searching for yet unexplored drug combinations that show therapeutic potential in IBD without the need of designing completely new drug entities."

Journal • Preclinical • Gastroenterology • Gastrointestinal Disorder • Immunology • Inflammation • Inflammatory Bowel Disease • IL1B • IL6 • MPO • TNFA

Intraarticular Hyaluronic Acid Preparations for Knee Osteoarthritis: Are Some Better Than Others? (PubMed, Cartilage) - "IAHA efficacy varies widely across preparations. High-quality studies are required to assess and compare the safety and efficacy of IAHA preparations."

Journal • Immunology • Osteoarthritis • Pain • Rheumatology

Delay to TKA and Costs Associated with Knee Osteoarthritis Care Using Intra-Articular Hyaluronic Acid: Analysis of an Administrative Database. (PubMed, Clin Med Insights Arthritis Musculoskelet Disord) - "Also, for patients who progressed to TKA, IA-HA treatment was associated with a large reduction in KOA-related healthcare costs. Based on these results, multiple, repeat courses of IA-HA may be beneficial in substantially delaying TKA in KOA patients, as well as minimizing KOA-related healthcare costs."

Journal • Immunology • Orthopedics • Osteoarthritis • Pain • Rheumatology

Non-Inferiority Study Comparing 3 Weekly Injections of SUPARTZ® vs 3 Weekly Injections of Euflexxa® for Knee OA (clinicaltrials.gov) - P=N/A; N=421; Completed; Sponsor: Bioventus LLC; Phase classification: P3 ➔ P=N/A

Clinical • Head-to-Head • Phase classification • Immunology • Osteoarthritis • Pain • Rheumatology

PPAR-δ agonist affects adipo-chondrogenic differentiation of human mesenchymal stem cells through the expression of PPAR-γ. (PubMed, Regen Ther) - "Previous study has reported that mixture of GW0742 (PPAR-δ agonist), hyaluronic acid (HA) and mesenchymal stem cells (MSCs) enhance chondrogenesis...MSCs were cultured with chondrogenic media and/or HA and/or GW0742 and/or rosiglitazone (PPAR-γ agonist) and/or human osteoarthritis synovial fluid...And clinical HA gels shows various efficacy of chondrogenesis. This study suggested that PPAR-γ and PPAR-δ are key regulatory factors of chondrogenesis."

Journal • Immunology • Inflammation • Osteoarthritis • Pain • Rheumatology • MMP13

[VIRTUAL] Evaluating the use of viscosupplementation for osteoarthritic knee pain in a health system (ASHP 2020) - "The products that the patients received included: Euflexxa, Hyalgan/Supartz, Gelsyn, Synvisc/Synvisc-One, Durolane, and Orthovisc. Patients from the population also could have received Gel-One, Hymovis, or Monovisc injections, but the number of patients receiving these products was less than twenty... There are six viscosupplementation products being used in the health system. When data from the various products was pooled together, less than half of patients noted at least moderate benefit from viscosupplementation. While the injections were shown to be very well tolerated, the lack of widespread benefit fell in line with AAOS not recommending viscosupplementation for osteoarthritic knee pain."

Immunology • Musculoskeletal Diseases • Musculoskeletal Pain • Orthopedics • Osteoarthritis • Osteoporosis • Pain • Rheumatology

Knee Osteoarthritis Treatment Costs in the Medicare Patient Population. (PubMed, Am Health Drug Benefits) - "Among patients who had knee arthroplasty, those who received treatment with hyaluronic acid had surgery delayed by a median of 10.7 months and associated costs for a significant period. The ability to delay or avoid knee arthroplasty altogether can have a substantial impact on healthcare costs."

Clinical • Journal • Medicare • Reimbursement • Immunology • Orthopedics • Osteoarthritis • Pain • Rheumatology

Adherence to the American Academy of Orthopaedic Surgeons Clinical Practice Guidelines for Nonoperative Management of Knee Osteoarthritis. (PubMed, J Arthroplasty) - "Adherence to the recommendations contained within the AAOS CPGs was modest regardless of the Kellgren-Lawrence grade or history of treatment. Given the size of the affected patient population, there is a need for uniformly accepted guidelines to clarify the role and timing of the different treatment interventions. CPGs should be combined with education, patient engagement, and shared decision-making to minimize variation in treatment patterns, improve patient outcomes, and lower overall costs of care."

Clinical • Clinical guideline • Journal • Immunology • Orthopedics • Osteoarthritis • Pain • Rheumatology

Contact-Triggered Lipofection from Multilayer Films Designed as Surfaces for In Situ Transfection Strategies in Tissue Engineering. (PubMed, ACS Appl Mater Interfaces) - "In vivo experiments using the chicken embryo chorion allantois membrane animal replacement model showed efficient gene transferring rates in living complex tissues, although the DNA loaded films were stored over 6 days under wet and dried conditions, respectively. Based on these findings it can be concluded that OH4/DOPE 1/1 lipoplex loaded polyelectrolyte multilayers composed of hyaluronic acid and chitosan can be an efficient tool for in situ transfection in regenerative medicine."

Journal • Gene Therapies