Monovisc vs Synvisc: Composition & Treatment
- Medical Community Member - October 5th 2018
Intraarticular injections of hyaluronic acid-based Monovisc, a product manufactured by Anika Therapeutics, and Synvisc, made by Genzyme, are used in the treatment of osteoarthritis of the knee. Patients considering such viscosupplements may need more information before deciding on the right product for them. To this end, this article will discuss the benefits of viscosupplementation, and describe the characteristics of Monovisc and Synvisc as well as the differences between them.
Monovisc or Synvisc for viscosupplementation
Patients with knee osteoarthritis, a type of arthritis in which the knee suffers damage due to the wearing down of the protective cartilage, often find themselves in pain or with joint stiffness that limits their mobility and impedes on their daily activities. Thus, managing this condition by alleviating the symptoms of knee osteoarthritis is of prime importance, so that the patient can improve their quality of life.
Currently, the methods of managing knee osteoarthritis include pain medications such as acetaminophen, physical therapy, weight loss management (if obesity is a factor). In addition, second-line medications like intraarticular corticosteroids and intraarticular hyaluronic acid can be employed if the previously mentioned treatments failed to produce an adequate clinical response.
Intraarticular hyaluronic acid injections are a form of viscosupplementation therapy. Viscosupplements are used to lubricate and cushion the affected joint in order to prevent further progression and reduce symptoms of the disease. They are able to achieve this because they are designed to be similar, both in composition and physical characteristics, of human synovial fluid, a component found in the knee joint that plays a vital role in the lubrication of the joint.
How do the orthopedic injections Monovisc and Synvisc differ from each other?
Synvisc has a composition that is unique among all hyaluronic acid viscosupplements. The main ingredient in Synvisc is a cross-linked derivative of hyaluronic acid that is made up of two polymers, hylan A (a soluble, high-molecular weight molecule that makes up 80% of the compound) and hylan B (an insoluble gel-like continuous molecular network that makes up the remaining 20% of the compound). In contrast, Monovisc is made of cross-linked hyaluronan of high molecular weight.
Hyaluronic acid sources
The hyaluronic acid in Monovisc is derived from bacterial fermentation, whereas the hylan that makes up Synvisc is produced from rooster combs. Thus, patients with hypersensitivity to avian proteins, feathers or egg products may consider Monovisc to be the more suitable treatment for them.
It is thought that Synvisc better imitates the rheological properties of healthy synovial fluid, which could impact its effectiveness in providing adequate lubrication to the joint.
Synvisc is associated with acute local reactions in the knee. These reactions have been shown to increase in frequency in patients receiving more than one course of treatment. Similar reactions have not been reported with other viscosupplements, including Monovisc.
Monovisc is a single dose treatment course, while Synvisc requires multiple sessions, consisting of a weekly injection for a total of 3 weeks. In this regard, Monovisc may be the more convenient option for patients who may not want the hassle of multiple visits to the doctor.
Intraarticular injections of hyaluronic acid can be a safe and convenient method of alleviating the symptoms associated with knee osteoarthritis. However, not all viscosupplements are the same, so patients should talk to their doctor about the best viscosupplement for them.