Medical Journal Studies on Adverse Reactions / Side-Effects of Synvisc

Here are quotes from research that appeared in peer-reviewed medical journals.

Department of Orthopaedic Surgery, Louisiana State University Health Sciences Center, Shreveport, LA 71130-3932, USA.
The flare reaction after treatment with Synvisc probably is not a Type-1 (antibody-mediated) hypersensitivity reaction, but may be a Type-4 (cell-mediated) hypersensitivity reaction.
http://ortho.sh.lsuhsc.edu/Faculty/Marino/Papers/139CORR2006.pdf.

[Hypersensitivity reactions are typical when the causative agent is a synthetic chemical]

Moreover, some of these drugs based on chemically modified HA, such as Synvisc®, have been involved in reports of sometimes serious adverse events (Hammesfahr JF. et al . , The American Journal of Orthopaedics, 2003, 32:277-283), probably following' the onset of inflammatory processes, especially linked with eosinophil recruitment (Schiavinato A. et al . , Clinical and Experimental Rheumatology, 2002, 20:445-454). Considering the above, new chemical derivatives of HA are being studied that enable the problems linked with both residence time in the joint cavity and the risk of toxicity due to solvents and/or particular chemical agents used in the chemical modification of HA [Synvisc] to be overcome, while maintaining all the characteristics and intrinsic properties of the polysaccharide, unaltered.

From this site http://www.ejbjs.org/cgi/content/extract/85/10/2050

"...Increased Frequency of Acute Local Reaction to Intra-Articular Hylan GF-20 (Synvisc) in Patients Receiving More Than One Course of Treatment" (2002;84:1619-23), by Leopold et al., ... We have seen about 25 similar reactions to hylan G-F 20 [Synvisc] but have not seen such reactions to the naturally extracted sodium hyaluronate, suggesting these adverse reactions are not a hyaluronan class effect. Reactions (painful effusion with cellular infiltrate and negative culture) occurred within 24 hours after an injection, presented in the second series of injections or later, and generally required intervention. Some cases improved within days after intra-articular injection, while others were more prolonged. [Full Text of this Article]


J Rheumatol. 1996 May;23(5):944-5; author reply 946. J Rheumatol. 1996 May;23(5):945-6.
Acute local reactions after intraarticular hylan for osteoarthritis of the knee.
Puttick MP, Wade JP, Chalmers A, Connell DG, Rangno KK.
Department of Medicine, University of British Columbia, Vancouver, Canada.
OBJECTIVE. To describe acute local reactions following intraarticular hylan injection and determine their frequency. .. RESULTS. Twenty-two patients had 88 injections to 28 knees. Six patients had reactions within 24 h of injection characterized by pain, warmth, and swelling, lasting up to 3 weeks. This occurrence was unpredictable. Corticosteroid injections were sometimes required. .... CONCLUSION. Intraarticular hylan [Synvisc] was associated with significant local inflammatory reactions in 27% of patients, or 11% of injections. The mechanism(s) and long term sequelae are unclear.

PMID: 7562764 [PubMed - indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/pubmed/18050181?ordinalpos=4&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum
Arthritis Rheum. 2007 Dec 15;57(8):1410-8.

Hylan versus hyaluronic acid for osteoarthritis of the knee: a systematic review and meta-analysis.
Reichenbach S, Blank S, Rutjes AW, Shang A, King EA, Dieppe PA, Jüni P, Trelle S.
University of Berne, Berne, Switzerland.
OBJECTIVE: To compare the effectiveness and safety of intraarticular high-molecular hylan with standard preparations of hyaluronic acids in osteoarthritis of the knee. ... CONCLUSION: Given the likely lack of a superior effectiveness of hylan [Synvisc] over hyaluronic acids and the increased risk of local adverse events associated with hylan [Synvisc], we discourage the use of intraarticular hylan [Synvisc] in patients with knee osteoarthritis in clinical research or practice.
PMID: 18050181 [PubMed - indexed for MEDLINE]

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