Clinical Papers and Publications
Curated peer-reviewed publications, ClinicalTrials.gov registry links, and full reference list for use in clinical decision-making
Peer-Reviewed Publications
Full Title
Intraarticular injection of a cross-linked sodium hyaluronate combined with triamcinolone hexacetonide (Cingal) to provide symptomatic relief of osteoarthritis of the knee: a randomized, double-blind, placebo-controlled multicenter clinical trial.
Key Takeaways
- Randomized, double-blind, placebo-controlled multicenter trial evaluating Cingal (cross-linked sodium hyaluronate + triamcinolone hexacetonide) for knee osteoarthritis
- Patients (n=368) received either Cingal, hyaluronic acid alone, or saline placebo.
- Cingal group showed significantly greater pain relief at early time points (weeks 1–3) compared to both comparators.
- Sustained improvement in WOMAC scores through 26 weeks, especially in pain and function domains.
- No serious adverse events reported; safety profile comparable across all groups.
- Conclusion: Cingal provides rapid and sustained symptom relief in knee OA, combining the benefits of HA and corticosteroid in a single injection.
Full Title
Cost-Utility of a Single-Injection Combined Corticosteroid-Hyaluronic Acid Formulation vs a 2-Injection Regimen of Sequential Corticosteroid and Hyaluronic Acid Injections
Key Takeaways
- Cost-utility analysis comparing a single-injection formulation of corticosteroid + hyaluronic acid (Cingal) vs. a 2-injection regimen of sequential corticosteroid and HA.
- Single-injection Cingal was found to be cost-effective, assuming a willingness-to-pay threshold of $50,000 per quality-adjusted life year (QALY) gained.
- Economic modeling showed lower overall treatment costs and comparable sustained symptom relief with the single-injection approach.
- Simplified administration and reduced patient burden make Cingal a favorable option in clinical practice.
- Conclusion: Cingal offers a cost-effective and efficient alternative to multi-injection regimens for knee OA symptom management.
Full Title
Increased Chondroprotective Effect of Combining Hyaluronic Acid with a Glucocorticoid Compared to Separate Administration on Cytokine-Treated Osteoarthritic Chondrocytes in a 2D Culture
Key Takeaways
- In vitro study using human osteoarthritic chondrocytes treated with inflammatory cytokines (IL-1β and IL-17) to simulate OA conditions.
- Compared effects of glucocorticoid (triamcinolone hexacetonide), hyaluronic acid (HA), and their combination on chondrocyte health and inflammation.
- Combined GC/HA treatment enhanced metabolic activity, reduced catabolic gene expression, and lowered TNF-α release more effectively than either agent alone.
- HA mitigated the negative cellular effects of glucocorticoids, such as reduced actin polymerization and increased oxidative stress.
- Conclusion: Co-administration of HA and GC offers superior anti-inflammatory and chondroprotective effects compared to separate administration, supporting the rationale for combination therapies in OA management.
