Dr. David Crawford: Triluron now available for knee pain


Dr. David Crawford, an orthopedic surgeon, shares that Fidia Pharma USA has announced the launch of Triluron, a hyaluronic acid-based intra-articular viscosupplement that is indicated for the treatment of pain in osteoarthritis of the knee for patients who have failed to respond adequately to the usual medications for the condition. The product contains 20mg of sodium hyaluronate, administered via intra-articular injection weekly for a total of three injections. As of press time, it has not yet been established if a single cycle of less than three injections is as effective as the regular cycle. The product is supplied in 2 ml vials or 2 ml pre-filled syringes and is intended for single use. Bilateral treatment requires the use of separate vials or syringes for each knee.

The chemical formulation of Triluron is identical to the company’s five-injection regimen, Hyalgan. Studies conducted by the company show that Triluron was not inferior compared to Hyalgan based on a retrospective analysis of data collected from two randomnized controlled trials. Health care providers must be aware of patients’ allergies and exercise caution when injecting the product into patients who are allergic to avian proteins, feathers, and egg products, as Triluron is extracted from rooster combs.

Hyaluronic acid works by acting as a lubricant and shock absorber, so the joints are able to move fluidly. It also interferes with prostaglandins and cytokines, naturally occurring compounds that promote inflammation. It may also coax the joint into increasing its own production of this substance, which ultimately helps in preserving the cartilage, thus possibly slowing the disease down. Dr. David Crawford recommends patients to discuss this option with their surgeons, especially if they are no longer able to tolerate the pain with ibuprofen or other nonsteroidal anti-inflammatory drugs, which can cause side effects such as stomach bleeding and kidney problems.

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