Hymovis® (Fidia Farmaceutici) offers a distinct approach to knee osteoarthritis (OA) pain relief. This HA viscosupplement uses HYADD®4 hydrogel technology for prolonged joint action, delivered in a two-injection series. This guide details its technology, clinical use, and safety for medical professionals.

(This guide is for trained medical professionals experienced in intra-articular injections. Adherence product guidelines is essential.)

Hymovis®: Understanding the HYADD®4 Technology and Composition

Hymovis® is distinguished by its specific formulation and the technology behind it:

• Active Ingredient: It is a high molecular weight, modified sodium hyaluronate (hyaluronan) derivative, specifically the hexadecylamide derivative of hyaluronan, known as HYADD®4.
• HYADD®4 Technology Explained: This proprietary technology creates a highly viscoelastic hydrogel. The hexadecylamide modification to the HA molecule makes it more resistant to enzymatic degradation (hyaluronidases) within the joint. This inherent stability is designed to increase its intra-articular residence time, potentially prolonging its therapeutic action compared to some traditional, unmodified HA formulations.
• Source: The hyaluronic acid used in Hymovis® is derived from bacterial fermentation (non-avian source), which minimizes the risk of avian-related allergic reactions in susceptible patients.
• Formulation: Hymovis® is typically supplied in a 3mL prefilled syringe containing 8mg/mL of the HYADD®4 hydrogel (total 24mg per syringe). It is important to note that Hymovis® does not typically come pre-mixed with lidocaine.

Mechanism of Action: How Hymovis® Provides Extended Symptomatic Relief

The primary therapeutic effect of Hymovis® in knee OA is achieved through enhanced viscosupplementation:

1. Restoring Synovial Fluid Viscoelasticity: The HYADD®4 hydrogel supplements and improves the quality of the native synovial fluid, which is often degraded in osteoarthritic joints.
2. Prolonged Lubrication & Shock Absorption: Due to its robust hydrogel structure and designed longer residence time, Hymovis® provides sustained lubrication between articular cartilage surfaces and enhances the shock-absorbing capacity of the knee joint during weight-bearing activities.
3. Potential for Extended Action: The unique chemical modification of the HA (hexadecylamide derivative) is key to its extended duration within the joint space. This prolonged presence aims to provide a more durable symptomatic benefit from its two-injection course.

Clinical Applications & Patient Selection (Knee OA Indication)

Hymovis® is globally indicated for the treatment of pain in osteoarthritis (OA) of the knee.

• Target Patient Profile: Ideal candidates are typically those with mild to moderate knee OA who continue to experience pain despite conservative non-pharmacologic therapies (e.g., physical therapy, exercise) and simple analgesics (e.g., acetaminophen). It is suitable for patients who may prefer a shorter injection series (two injections) compared to traditional 3-5 injection regimens.
• Contraindications: Practitioners must thoroughly screen for contraindications, which include:
  • Known hypersensitivity to hyaluronan preparations or any component of Hymovis®.
  • Active knee joint infections or skin diseases/infections in the area of the intended injection site.
  • Significant joint effusion (excess fluid); if present, arthrocentesis should be performed before Hymovis® injection.
• Untested Populations: Standard precautions apply for pregnant or lactating women and individuals under 21 years of age, as extensive clinical data in these populations is generally lacking.

Administration Protocol: The Two-Injection Regimen

The specific two-injection protocol is a defining feature of Hymovis® treatment:

• Dosing Schedule: Hymovis® is administered as two 3mL intra-articular injections into the affected knee joint, spaced one week apart.
• Aseptic Technique: Strict adherence to aseptic technique is absolutely paramount for all intra-articular injections to prevent the potentially devastating complication of septic arthritis. This involves thorough skin preparation, use of sterile gloves, and maintaining sterility of all equipment.
• Injection Procedure: Injections should be performed by a medical professional trained and experienced in intra-articular knee injection techniques. The appropriate needle size (e.g., 18-21 gauge, as per IFU) should be used. If joint effusion is present, it should be aspirated prior to injecting Hymovis®.
• Anesthesia: As Hymovis® does not contain an integrated anesthetic, practitioners should consider topical anesthesia, cryoanesthesia, or other appropriate pain management strategies to enhance patient comfort during the injection.

Clinical Efficacy & Patient Outcomes

Clinical studies have demonstrated the efficacy of Hymovis® in providing significant and sustained pain relief for patients with knee OA.

• Pain Reduction & Functional Improvement: Trials have shown that the two-injection course of Hymovis® leads to a significant reduction in knee pain and improvement in joint function compared to placebo (saline injections).
• Duration of Effect: Benefits are often observed to extend for at least 6 months post-treatment, with some studies suggesting continued efficacy beyond this period. The prolonged intra-articular residence of the HYADD®4 hydrogel is believed to contribute to this sustained effect.
• Patient Expectations: It is important to counsel patients that while pain relief can be substantial, Hymovis® treats the symptoms of OA and is not a cure. The onset of maximum benefit may be gradual over a few weeks after the completion of the two-injection series.

Safety Profile & Potential Side Effects

Hymovis® is generally well-tolerated when administered according to the IFU and by trained professionals.

• Common Adverse Events: Most reported side effects are mild to moderate, transient, and localized to the injection site. These include:
  • Arthralgia (joint pain)
  • Joint stiffness
  • Joint effusion (swelling)
  • Injection site pain
  • Redness or bruising at the injection site
• Serious Risks (Though Rare):
  • Septic Arthritis: As with any intra-articular procedure, this is the most significant potential complication. Meticulous aseptic technique is the primary preventative measure. Symptoms include acute severe pain, significant swelling, warmth, fever, and systemic illness, requiring immediate medical intervention.
  • Hypersensitivity/Allergic Reactions: Possible, though rare with non-avian sourced HA.
  • Acute Inflammatory Reactions (Pseudo-sepsis): A non-infectious, significant inflammatory response in the joint can occasionally occur.

Practitioners must consult the complete product Instructions For Use (IFU) specific to their region for comprehensive safety information, warnings, and precautions.

Sourcing Authentic Hymovis®

To ensure patient safety and optimal treatment outcomes, the use of genuine, properly stored medical products is essential.

• Practitioners should source Hymovis® only from authorized distributors of Fidia Farmaceutici or reputable, licensed B2B medical suppliers like Health Supplies Plus.
• Always verify product packaging, labeling, lot numbers, and expiry dates to confirm authenticity and product integrity.
• Be aware of the significant risks associated with counterfeit or improperly handled intra-articular injectables.

Conclusion

Hymovis®, with its unique HYADD®4 hydrogel technology and convenient two-injection regimen, offers a valuable and effective option for the symptomatic treatment of knee osteoarthritis. Its design for prolonged intra-articular residence aims to provide sustained pain relief and functional improvement for appropriate patients.

Doris Dickson

About the Author: Doris Dickson is a specialist writer for Health Supplies Plus, focusing on the aesthetic medicine industry. She diligently researches cosmetic treatments and products to provide clear, concise information relevant to licensed medical professionals. Her work supports Health Supplies Plus’s commitment to being a reliable informational resource and trusted supplier for the aesthetic community.

 

Disclaimer: The content provided in this article is intended for informational purposes only and is directed towards licensed medical professionals. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment, nor does it constitute an endorsement of any specific product or technique. Practitioners must rely on their own professional judgment, clinical experience, and knowledge of patient needs, and should always consult the full product prescribing information and relevant clinical guidelines before use. Health Supplies Plus does not provide medical advice.