Supartz Injections for Knee Osteoarthritis

Supartz injections are used to treat knee osteoarthritis. The Supartz solution is injected directly into the knee joint to restore the cushioning and lubricating properties of the synovial fluid (joint fluid).

Supartz, a solution of sodium hyaluronate, is one of the hyaluronates used in viscosupplementation.

A patient getting a knee injection
GARO / PHANIE / Getty Imaged

The sodium hyaluronate used in Supartz is extracted from chicken combs. Sodium hyaluronate is a polysaccharide (a type of sugar molecule) that contains repeating disaccharide units of glucuronic acid (which helps eliminate toxins) and N-acetylglucosamine (which has anti-inflammatory properties).

Approval of Supartz and Supartz Fx

Supartz is approved for the treatment of knee osteoarthritis in patients who have not obtained sufficient relief with conservative treatments, such as exercise, physical therapy, pain medications, mobility aids, and hot or cold packs.

Supartz is injected once a week for a 5-week cycle. Some patients may have a good response after 3 weeks.

Its use of other joints is being investigated.

Supartz was approved by the U.S. FDA on January 24, 2001, and it has been used in Japan since 1987.

On October 12, 2015, Bioventus, the maker of Supartz, announced the launch of Supartz Fx, which contains 10 milligrams (mg) sodium hyaluronate dissolved in 1.0% physiological saline. Supartz Fx has an expanded label from the original Supartz, allowing for repeat injection cycles. While the safety label was expanded for repeat cycles of injection, the effectiveness of repeat cycles has not been established.

Recommendations

The American College of Rheumatology's position is as follows:

  1. The American College of Rheumatology recommends the use of intraarticular hyaluronic acid injection for the treatment of osteoarthritis of the knee in adults, in accordance with the ACR 2012 OA guidelines.
  2. Hyaluronic acid injection is clinically indicated for the management of osteoarthritis in patients who are not good candidates or who do not respond to other treatment options.
  3. The American College of Rheumatology supports patient access to appropriate therapies including hyaluronic acid injection.

Supartz Warnings and Precautions

You should not have treatment with Supartz if you have a hypersensitivity to sodium hyaluronate products. And your doctor would use caution when considering this treatment for you if you are allergic to avian proteins, eggs, or feathers. And you should not have an injection in an area of skin affected by a skin infection or skin disease. 

The safety and effectiveness of Supartz have not been established in pregnant women, nor in lactating women. Its use has not been studied in children.

Common Side Effects of Supartz Injections

Common side effects or adverse events associated with Supartz include:

  • Joint pain without inflammation
  • Back pain
  • Non-specific pain
  • Injection site reaction
  • A headache

Transient swelling or pain can occur in a joint that has been injected with Supartz.

Patients are advised to avoid strenuous or weight-bearing activities in the 48 hours following injection.

The Bottom Line

An analysis of five well-designed clinical trials revealed no significant difference between Supartz and control groups in terms of adverse events. While the safety of Supartz and the other viscosupplements has been upheld by clinical studies, effectiveness has been debated.

Regarding effectiveness, a Cochrane Review concluded that viscosupplementation is more effective than placebo but there were other studies that fell short on proving that the injections provide significant pain relief.

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Article Sources
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  1. Bioventus launches Supartz Fx now With expanded safety label for repeat injection cycles in knee osteoarthritis. October 12, 2015.

  2. American College of Rheumatology Position Statement. Intra-articular hyaluronic acid injection in osteoarthritis of the knee. 2014

  3. Drugs.com. Supartz (injection). Multum C

  4. Hyaluronic Acid (Supartz): A review of its use in osteoarthritis of the knee. Curan MP. Drugs & Aging. November 2010. doi:10.2165/11205920-000000000-00000

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