From the Guidelines
The efficacy of hyaluronic acid (HA) products varies due to factors such as molecular weight, dosage, and individual patient response.
Factors Contributing to Varying Efficacy
- Molecular weight: High molecular weight HA preparations may have a superior effect compared to low molecular weight preparations 1
- Dosage: The optimal dosage of HA has not been established, and varying dosages may affect efficacy 1
- Individual patient response: Patients may respond differently to HA treatment, and predictors of response are not well defined 1
Determining the Most Suitable Product
- Consideration of patient characteristics: Patients with mild to moderate symptomatic OA of the knee may benefit from HA treatment, but the size effect is relatively small 1
- Evaluation of available evidence: The evidence for HA treatment is not strong, and the quality of trials varies, which can influence the results 1
- Shared decision-making: The decision to use HA treatment should be made in consultation with the patient, taking into account the limited evidence of benefit and potential harms 1
Evidence-Based Recommendations
- EULAR recommendations: HA is probably effective in knee OA, but the size effect is relatively small, and suitable patients are not well defined 1
- AAOS recommendations: The evidence for HA treatment is inconclusive, and a recommendation for or against its use cannot be made 1
From the Research
Factors Contributing to Varying Efficacy of HA Products
- Physiochemical properties, such as HA concentration, cross-linking percentage, and particle size, can influence treatment effectiveness, safety, and longevity 2
- Cross-linking technologies used in HA gel production can affect their mechanical, rheological, and pharmacological properties 3
- Bioavailability, tolerance, and adverse effects of HA products can also impact their efficacy 4
- The behavior of HA gels, including cohesivity, resistance to stretch, and microscopic properties, can vary depending on the cross-linking technology used 3
Determining the Most Suitable HA Product
- Physicians should consider the specific indication and patient needs when selecting an HA product 3
- Simple laboratory tests, such as cohesivity and resistance to stretch tests, can help physicians evaluate the properties of different HA gels 3
- Familiarity with the differences in HA and hyaluronidase products is essential for cosmetic practitioners to achieve optimal results 5
- The durability, behavior, and tolerability of HA products can be affected by the interaction between HA fillers and hyaluronidase products, highlighting the importance of understanding these interactions 5