Cingal Overview
Cingal is a next-generation, non-opioid single-injection therapy for the symptomatic treatment of knee osteoarthritis (OA).1 It combines hyaluronic acid (HA) viscosupplementation with a corticosteroid (triamcinolone hexacetonide) in one pre-filled syringe, delivering both rapid onset and sustained pain relief.2 Cingal is designed to work through both biological and mechanical mechanisms, reflecting the multiple factors involved in OA symptoms.
Dual-action in a single injection
Cingal is administered via intra-articular injection during a routine office visit and is intended for patients with mild to moderate knee OA who require prompt symptom relief without repeated injections.
Corticosteroid
Triamcinolone Hexacetonide (TH)
Rapid anti-inflammatory relief
TH rapidly suppresses intra-articular inflammation, reducing pain within days of injection. Its low aqueous solubility and high receptor binding affinity support a sustained local effect of approximately 21 days.3
Onset: within days2
Viscosupplement
Hyaluronic Acid (HA)
Sustained joint lubrication
Cross-linked, non-animal-sourced HA restores synovial fluid viscoelasticity, supporting lubrication, shock absorption, and longer-term symptom improvement. Bacterial fermentation source ensures no avian-derived components.
Duration: up to 6 months2
Real Life Advantages
Cingal’s dual-component formulation addresses both the acute and chronic stages of knee OA, providing clinicians with a convenient single-injection treatment option.
Dual-action mechanism
Rapid anti-inflammatory effect from TH plus long-term joint lubrication and cushioning from cross-linked HA, both delivered in a single injection.2
Clinically proven efficacy
Three Phase III clinical trials demonstrating sustained benefit through 6 months, including OMERACT-OARSI responder analysis.2,4,5
Non-opioid pain management
Aligned with contemporary OA and chronic pain pathways that prioritise non-opioid, intra-articular approaches for moderate-to-severe symptoms.
Proven clinical use in knee OA
Indicated for the relief of pain, stiffness, and functional limitation associated with knee osteoarthritis. Relevant across orthopaedic, rheumatology, pain, and MSK specialties.1,2
Non-animal HA source
Hyaluronic acid produced by bacterial fermentation, with no avian-derived components. Relevant for patients with known avian sensitivities.1
High HA concentration
22 mg/mL cross-linked HA (high molecular weight within the biologically relevant range, cross-linked to extend intra-articular residence time).1
Single-injection convenience
One visit, one sterile pre-filled syringe, reducing procedural burden in high-throughput orthopaedic, rheumatology, and MSK clinics.6
Registered in 45+ countries
Approved and in active clinical use in over 45 countries worldwide7, with an established post-market safety and repeat-injection record.8
Explore Cingal in Depth
Learn More About Cingal
Complete clinical product profile: formulation science, HA cross-linking, TH mechanism, chondroprotective data, and clinical profile at a glance.
Comparison to Other Therapies
Head-to-head overview: Cingal vs. corticosteroid-only, HA-only, and sequential injection approaches, including place-in-therapy pathway.
Continue your clinical evaluation
Phase III evidence data, administration and patient selection criteria
- Instructions for Use. Cingal. Anika Therapeutics. [Refer to current IFU for approved indications.]
- Hangody L, et al. 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. Cartilage. 2018;9(3):276–283. doi: 10.1177/1947603517703732.
- Stephens M., et. al. Musculoskeletal Injections: A Review of the Evidence. Am Fam Physician. 2008 Oct 15;78(8):971-976
- Data on file 16-02
- Data on file 19-01
- Belzile EL, Deakon RT, Vannabouathong C, Bhandari M, Lamontagne M, McCormack R. Cost-Utility of a Single-Injection Combined Corticosteroid-Hyaluronic Acid Formulation vs a 2-Injection Regimen of Sequential Corticosteroid and Hyaluronic Acid Injections. Clin Med Insights Arthritis Musculoskelet Disord. 2017 Jun 12
- Anika Sales Data on File
- Data on file 13-02
