Supartz Injections for Knee Osteoarthritis

doctor giving knee injection

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Supartz, a solution of sodium hyaluronate, is one of the hyaluronates used in viscosupplementation. Supartz is injected directly into the knee joint to restore the cushioning and lubricating properties of the synovial fluid (i.e., joint fluid).

The sodium hyaluronate used in Supartz is extracted from chicken combs. Sodium hyaluronate is a polysaccharide which contains repeating disaccharide units of glucuronic acid and N-acetylglucosamine.

Approval of Supartz and Supartz Fx

Supartz was approved by the U.S. FDA on January 24, 2001, for the treatment of knee osteoarthritis in patients who failed to obtain sufficient relief with conservative treatments, including exercise, physical therapy, pain medications, mobility aids, and hot or cold packs. Use of other joints is being investigated. Supartz was used in Japan since 1987. It is injected once a week for a 5-week cycle. Some patients may have a good response after 3 weeks.

On October 12, 2015, Bioventus, the maker of Supartz, announced the launch of Supartz Fx (10 mg sodium hyaluronate dissolved in 1.0% physiological saline), which 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.

Supartz Warnings and Precautions

Supartz should not be administered to any patient with known hypersensitivity to sodium hyaluronate products. Caution should be used when treating patients with known allergy to avian proteins, eggs, or feathers. Patients with an infection or skin disease in the area where the injection would be given should not be treated with Supartz. 

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

Swelling or pain, which is transient, 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 5 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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