Resistance to enzymatic degradation and efficacy evaluation of crosslinked hyaluronic acid based commercial viscosupplements for knee osteoarthritis treatment

• Published in: Carbohydrate polymer technologies and applications Vol. 6; p. 100392
• Main Authors: Andrade del Olmo, Jon, Sáez Martínez, Virginia, Martínez de Cestafe, Nagore, Alonso, José María, Goenaga Ibeas, Claudia, Ucelay López de Heredia, Miguel, Benito Cid, Sandra, Pérez González, Raúl
• Format: Journal Article
• Language: English
• Published: Elsevier Ltd 01.12.2023; Elsevier
• Subjects: Commercial injectable hydrogels; Hyaluronic acid; Knee osteoarthritis; Sports medicine; Traumatology; Viscosupplementation; Knee osteoarthritis; Hyaluronic acid; Traumatology; Commercial injectable hydrogels; Viscosupplementation; Sports medicine
• ISSN: 2666-8939; 2666-8939
• DOI: 10.1016/j.carpta.2023.100392

•TrHCROSS®, Durolane®, Regenflex®Bio-plus and Monovisc® commercial samples were tested.•TrHCROSS® exhibit the greatest resistance to hyaluronidase enzymatic degradation.•TrHCROSS® is the most effective and durable HA viscosupplement to relief pain in KOA joint.•TrHCROSS® comply with the strictest endotoxin regulation of medical devices.•TrHCROSS® success is attributed to a novel HA crosslinking method: SARE® technology. A significant number of people worldwide suffers from knee osteoarthritis (KOA), a chronic and painful disease that is linked to aging, traumatological events and sports medicine. Clinical research indicates that KOA exhibit an altered synovial fluid (SF) with lower endogenous hyaluronic acid (HA) concentration and viscoelastic properties. Nowadays, viscosupplementation by intra-articular HA injections is the most common treatment to restore endogenous HA performance in osteoarthritic SF. In this work, TrHCROSS®, Durolane®, Regenflex®Bio-plus and Monovisc® commercial crosslinked HA viscosupplements were compared in vitro against enzymatic degradation. As key research point, TrHCROSS® demonstrated a considerably increased enzymatic stability compared to the rest of examined viscosupplements, which highlights TrHCROSS® prolonged residence time in joint space reducing more durably and effectively osteoarthritic knee pain. Subsequently, an in-depth physicochemical characterization was realized to support efficacy and stability results of viscosupplements. All in all, TrHCROSS®, developed by SARE® technology, was found to be more successful in treating more durably and effectively KOA based on the remarkable outcomes of conducted trials, which were appropriate findings for the current research investigation. [Display omitted]