Euflexxa vs Orthovisc – Which Is Better for OA?

Last Updated On: September 10, 2024

Osteoarthritis (OA) affects millions worldwide and causes joint pain, stiffness, and swelling. Viscosupplementation, a treatment involving hyaluronic acid injections into arthritic joints, aims to alleviate symptoms. Euflexxa and Orthovisc are two of the top choices among OA treatments. 

These treatments fall under the category of viscosupplementation agents but contain different formulations and exhibit differences that require attention. Both aim to alleviate osteoarthritis symptoms by providing joint lubrication and cushioning. 

In this article, we’ll discuss the efficacy, safety, and patient experiences of Euflexxa and Orthovisc to make informed treatment choices.

Key Takeaways

• Euflexxa and Orthovisc help with knee pain by adding fluid to the joints.
• Euflexxa uses bacterial-derived hyaluronic acid, while Orthovisc is derived from rooster combs; both alleviate osteoarthritis discomfort by enhancing joint lubrication.
• People get these shots over a few weeks, which helps them move better.
• Some prefer one treatment over the other due to varying side effects or differences in the duration of pain relief each provides.
• The cost can be important when deciding between Euflexxa and Orthovisc.

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Introduction to Euflexxa and Orthovisc

Osteoarthritis (OA) is a prevalent joint disorder characterized by cartilage degeneration, leading to joint pain, stiffness, and reduced mobility. Affecting millions globally, OA predominantly impacts the knees, hips, hands, and spine, posing significant challenges to daily activities and overall quality of life.

Euflexxa and Orthovisc are two prominent viscosupplements used in OA treatment, specifically for knee osteoarthritis. These treatments involve injecting hyaluronic acid directly into the knee joint to supplement the natural synovial fluid, enhancing lubrication and cushioning.

By mimicking the properties of natural joint fluid, Euflexxa and Orthovisc aim to reduce pain and improve joint function, offering relief for patients who do not respond adequately to other conservative treatments such as NSAIDs or physical therapy.

Composition and Mechanism of Action

Euflexxa contains 1% sodium hyaluronate, a non-avian-derived, bioengineered hyaluronic acid. The hyaluronic acid in Euflexxa is produced through bacterial fermentation, ensuring that it is free from avian proteins, which can reduce the risk of allergic reactions. 

Meanwhile, Orthovisc is made up of high molecular weight hyaluronan, a naturally occurring substance in the synovial fluid of joints. Orthovisc is also non-avian derived and contains one of the highest concentrations of hyaluronic acid among viscosupplements available.

Mechanism of Action

Euflexxa and Orthovisc work by mimicking the natural synovial fluid in the joints, which is typically reduced or degraded in individuals with osteoarthritis. This supplementation helps to restore the normal viscoelastic properties of the synovial fluid, providing several benefits:

• Lubrication: The hyaluronic acid in Euflexxa and Orthovisc helps lubricate the knee joint, reducing friction between the bones during movement. This lubrication is crucial for easing the pain associated with osteoarthritis and improving joint mobility.
• Shock Absorption: These injections enhance the viscoelasticity of the synovial fluid, acting as shock absorbers for the knee joint and protecting the cartilage from further wear and tear.
• Anti-inflammatory Effects: Hyaluronic acid has been shown to have anti-inflammatory properties, which can help reduce the inflammation often present in osteoarthritic joints. This can lead to decreased pain and swelling.
• Stimulation of Cartilage Repair: Both Euflexxa and Orthovisc can stimulate the synthesis of endogenous hyaluronic acid and other extracellular matrix components, which may promote cartilage repair and improve joint health over time.

Clinical Efficacy and Safety Profiles

Euflexxa has undergone rigorous clinical evaluation. In the FLEXX trial, a well-controlled study, Euflexxa demonstrated positive outcomes in knee OA patients over 26 weeks. Additionally, a 12-week trial comparing Euflexxa to Synvisc revealed powerful pain relief, with patients experiencing pain-free periods by the study’s end.

In the 26-week Flexx Extension Trial, Euflexxa improved OA knee pain based on a 50-foot walk test. While exploratory analyses shouldn’t infer causative relationships, Euflexxa’s efficacy and safety profile offer hope for patients seeking relief from knee OA.

As for Orthovisc, a systematic review of randomized trials spanning 50 years evaluated viscosupplementation, including Orthovisc, for knee osteoarthritis. While all viscosupplements share a safety profile, evidence supports their efficacy against placebo. However, it’s essential to note that Orthovisc’s effectiveness in joints other than the knee remains unestablished.

Recent research has not consistently demonstrated significant pain reduction or functional improvement with viscosupplementation, including Orthovisc. Experts acknowledge that some patients report relief, but overall effectiveness remains uncertain. 

Practical Considerations

Euflexxa and Orthovisc are both viscosupplements used in treating osteoarthritis (OA). These treatments involve injecting a solution into the knee joint to help lubricate and cushion it, relieving OA pain.

Treatment Protocols

• Euflexxa: Following the proper Euflexxa dosage, this is typically administered as a series of three intra-articular injections, given one week apart. This protocol aims to provide relief over a sustained period. Each injection contains 1 mL of 10 mg/mL hyaluronic acid solution.
• Orthovisc: Orthovisc is also administered through a series of three or four intra-articular injections, given one week apart. Each injection delivers 2 mL of a 15 mg/mL hyaluronic acid solution. The exact number of injections may vary based on the physician’s assessment of the patient’s condition and response to treatment.

Patient Satisfaction

Patient satisfaction with Euflexxa and Orthovisc is generally high, with many reporting significant reductions in pain and improvements in joint function. Euflexxa users often highlight its relatively mild injection-related discomfort and the absence of allergic reactions due to its non-avian origin. Orthovisc patients appreciate its high molecular weight formulation, which some studies suggest may offer enhanced efficacy and longer-lasting relief.

Duration of Relief

• Euflexxa: Relief from Euflexxa injections typically lasts up to six months, though some patients may experience benefits for a longer or shorter duration. The variability depends on individual patient factors, including the severity of osteoarthritis and overall health.
• Orthovisc: Similarly, Orthovisc can provide relief for up to six months. Some clinical studies have indicated that its high molecular weight might offer prolonged relief compared to other viscosupplements, but individual results can vary.

Cost Comparison between Euflexxa and Orthovisc

When comparing the costs of Euflexxa and Orthovisc, it’s important to note that prices can vary based on location, insurance coverage, and the healthcare provider. Generally, Euflexxa tends to be slightly more affordable than Orthovisc. On average, a single injection of Euflexxa costs around $348, while Orthovisc can be more expensive, though specific pricing details may vary.

Conclusion

Choosing between Euflexxa and Orthovisc depends on individual needs. Both treatments offer relief for osteoarthritis but differ in composition, action, and cost. Doctors consider these factors, plus patient feedback, to decide on the best option. Relief duration also plays a big role. So, there’s no clear winner; it’s about what works better for each person’s situation.

FAQs

1. What’s the difference between Euflexxa and Orthovisc?

Euflexxa and Orthovisc treat osteoarthritis (OA) but differ in their generic names, prescribing information, and other properties.

2. How effective are Euflexxa and Orthovisc for knee osteoarthritis patients?

Euflexxa and Orthovisc are both effective for knee osteoarthritis. Clinical studies show significant pain reduction and improved joint function for many patients. Both treatments provide relief for up to six months, though individual responses can vary.

3. Do Euflexxa and Orthovisc share the same ingredients?

No, Euflexxa and Orthovisc do not share the same ingredients. While both contain hyaluronic acid, Euflexxa uses a bio-fermentation process, whereas Orthovisc is derived from rooster combs.

References

Viscosupplementation Treatment for Arthritis. www.hopkinsmedicine.org. https://www.hopkinsmedicine.org/health/conditions-and-diseases/arthritis/viscosupplementation-treatment-for-arthritis 

Nicholls M, Manjoo A, Shaw P, Niazi F, Rosen J. A Comparison Between Rheological Properties of Intra-articular Hyaluronic Acid Preparations and Reported Human Synovial Fluid. Advances in Therapy. 2018;35(4):523-530. doi:https://doi.org/10.1007/s12325-018-0688-y