how long does it take for Synvisc-One to work? (+1 factors)
By
Ivan Kahwa
Author bio
Mr Ivan Kahwa is a chemist and phytopharmaceutical scientist with expertise in chemistry, pharmacology, phytochemistry, and Nanobiotechnology. He writes and reviews content on these topics.
Mr Ivan Kahwa’s Highlights:
Guest Researcher at the University of Leipzig, Senior Research Fellow/Scientist, and Lecturer at the Department of Pharmacy, Faculty of Medicine, Mbarara University of Science and Technology.
Professional Experience:
Mr Ivan joined PHARMBIOTRAC as a research fellow/scientist during his master of science tenure. He contributed to the development of most of the phytopharmaceutical products in the project. Furthermore, he participated in carrying out the pharmacological activities of the developed products in laboratory animals such as mice and rats in order to develop proper doses hence leading to pre-clinical studies.
With the above relevant research experience, Ivan started to work with the University of Leipzig on collaborative projects with Mbarara University to develop the chemistry of Ugandan Medicinal plants and their pharmacological activities. This was coupled with several consultative positions by different German NGOs. Mr. Kahwa is also a supporting in the teaching and learning at the Departments of Pharmacy and Pharmaceutical Sciences, Faculty of Medicine, Mbarara University of Science and Technology.
With the increase in antimicrobial resistance globally, Ivan retooled his thinking towards developing new naturally derived antibiotic regimens from Ugandan propolis with the assistance of nanotechnology to improve their delivery to microbial cells. Kahwa has also published over 28 articles in peer-reviewed journals and he is currently reviewing for many journals.
Education:
2023-2027: PhD in Pharmaceutical Sciences (ongoing) with a focus on Pharmaceutical Microbiology and Nanobiology at Mbarara University of Science and Technology.
2022: 2Msc. in Pharmacognosy and Natural Medicine Science at Mbarara University of Science and Technology.
2018: Bachelor of Science (Chemistry) at Mbarara University of Science and Technology.
Publications:
▪ Iqbal, S., Jabeen, F., Kahwa, I., & Omara, T. 2023. Suberosin Alleviates Thiazolidinedione-Induced Cardiomyopathy in Diabetic Rats by Inhibiting Ferroptosis via Modulation of ACSL4-LPCAT3 and PI3K-AKT Signaling Pathways. Cardiovascular Toxicology. https://doi.org/10.1007/s12012-023-09804-7
▪ Gupta, A. K., Yadav, R., Sharma, S., Sawale, J., & Kahwa, I. 2023. Anti-ageing Activity and Antioxidant Activity of Methanol Extracts of Leaves and Flowers of Salvia officinalis and Rosmarinus officinalis. Journal of Young Pharmacists, 15(3), 448–455. https://doi.org/10.5530/jyp.2023.15.60
▪ Tolo, C.U., Kahwa, I., Nuwagira, U., Weisheit, A. and Ikiriza, H., 2023. Medicinal plants used in treatment of various diseases in the Rwenzori Region, Western Uganda. Ethnobotany Research and Applications, 25, pp.1-16.
https://ethnobotanyjournal.org/index.php/era/article/view/4683
▪ Kahwa, I., Ajayi, C.O., Yadav, R., Chauhan, N.S., Shah, K., Abdelgadir, A.A., Shegena, E.A., Daniel, S., Omara, T., Asiimwe, J.B. and Ikiriza, H., 2023. Pharmacognostic and phytochemical studies as an invaluable approach for correct identification of medicinal plants: The case of Artemisia vulgaris L. substituted for Artemisia annua L. in Western Uganda. TMR Integr Med, 7, p.e23004.
https://doi.org/10.53388/TMRIM202307004
▪ Nalimu, F., Oloro, J., Kahwa, I. and Ogwang, P.E., 2021. Review on the phytochemistry and toxicological profiles of Aloe vera and Aloe ferox. Future Journal of Pharmaceutical Sciences, 7, pp.1-21.
https://doi.org/10.1186/s43094-021-00296-2
▪ Elamin, O.H.S., Ali, M.A., Elgezuli, I.A.A., Bashir, M.A. and Kahwa, I., 2021. Diagnosis of pre-and post-treatment of echinococcus granulosus with counter current immune electrophoresis and bacterial co-agglutination. Journal of Microbiology and Infectious Diseases, 11(02), pp.88-94.
https://doi.org/10.5799/jmid.951600
Published book Chapter
▪ Kahwa, I., Ayesiga, I., Nakalema, S., Alinaiswe, R., Mbabazi, R. and Iqbal, S., 2023. Natural products in the management of onchocerciasis. In Natural Products in Vector-Borne Disease Management (pp. 63-80). Academic Press. Book Chapter.
https://doi.org/10.1016/B978-0-323-91942-5.00012-4
Submitted manuscripts Under Review:
▪ Comparison of the Wound Healing Activity of the Leaf and Leaf Ash Extracts of Vernonia amygdalina in Rats. Journal name: Clinical Phytoscience
▪ Ethnobotanical Survey of Medicinal plants used in the management of cancer in Uganda. Journal name: Journal of Herbal Medicine
▪ Ethnobotanical survey and phytochemical screening of medicinal plants used in treatment of epilepsy by PROMETRA-Uganda Traditional Health Practitioners in Mpigi District, Uganda. Journal name: Journal of Ethnopharmacology
Submitted book chapters under review
1.Book title: Algae as a Natural Solution for Water-Food-Energy Nexus, Section 4: Microalgae and cyanobacteria for food applications, Chapter 4.6: Safety, toxicological and allergenic aspects of using algae for food. Authors: Christine Kyarimpa, Tom Omute, Caroline K. Nakiguli, Alice V. Khanakwa4, Christopher Angiro, Ivan Kahwa, Fortunate Ahumuza, Timothy Omara*. Publisher: Springer Nature Singapore Pte Ltd. 152 Beach Road, #21-01/04 Gateway East, Singapore 189721, Singapore.
2.Book title: Nutraceuticals Inspiring the Contemporary Therapy for Lifestyle Diseases. Chapter: Nutraceutical applications of Seaweeds and their Phytocompounds in Nutrition and Treatment of Diseases. Authors: Ivan Kahwa, Timothy Omara , Innocent Ayesiga , Gael Noel Neh Neba Ambe , Zehbanaz Javidbhai Panwala , Rachel Mbabazi , Shabnoor Iqbal , Christine Kyarimpa , Christine Betty Nagawa , Kamal Shah ,Nagendra Singh Chauhan* Publisher: CRC Press
You can view my works on the following professional sites:
Research Gate: https://www.researchgate.net/profile/Ivan-Kahwa
Google Scholar: https://scholar.google.com/citations?user=tOwrvqoAAAAJ&hl=en
ORCID: https://orcid.org/0000-0002-6440-3437
Linkedin: https://de.linkedin.com/in/ivan-kahwa-865450159
In this article, we will discuss how long it takes for Synvisc-One to work. We will also discuss some alternatives if Synvisc-One does not effectively reduce the osteoarthritis pain.
How long does it take for Synvisc-One to work?
Synvisc-One shows osteoarthritic pain relief after the first injection. However, Synvisc-One may take 8-12 weeks to give the greatest relief from osteoarthritic pain. Some patients have reported a reduction in pain after 4 weeks of injection (1).
Therefore, Synvisc-One onset of action varies between individuals. Although all patients respond variably to the treatment, Synvisc-One may provide up to six months of osteoarthritic pain relief after the first dose (2).
The injection may be repeated after six months, depending upon the severity of the disease. As Synvisc-One is injected directly into the knee joint, your healthcare provider will give you this injection.
Inform your doctor if you experience any side effects after Synvisc-One administration, including pain, swelling, redness, or fluid retention around the knee. Do not use this injection if you are allergic to hyaluronan-based products.
How to know if Synvisc-One is working?
You may get osteoarthritic pain relief after the first injection of Synvisc-One. Synvisc-One also reduces stiffness in the knee, improves knee function, and reduces joint swelling. The effect may last up to 6 months (2).
It is recommended that you refrain from physical activities, exercise, or putting undue stress on your knee for approximately 48 hours after taking the injection. However, walking, standing, and other routine activities are permitted.
What does research suggest?
In one of the randomized, controlled clinical studies, 112 patients showed significant improvement in osteoarthritic pain relief, swelling, and mobility for up to 6 months after receiving Synvisc-One. The patients reported no side effects after the injection (2).
In one of the case reports, the use of Synvisc-One caused bilateral joint pain and swelling in a 72-year-old man. The elevated inflammatory markers indicated systemic inflammatory polyarthritis after 2 days of injecting Synvisc-One (3).
Factors affecting the time taken by Synvisc-One to work
Some factors may delay the time taken by Synvisc-One to work properly. You should follow the dosage regimen of Synvisc-One as decided by your doctor to get the most benefit.
| Factor | Reason |
| Individual variability | Some individuals feel symptomatic pain relief after the first injection of Synvisc-One. However, others may experience pain relief after 8-12 weeks of treatment. These differences may be attributed to genetics, changes in metabolism, and the overall health status of the patient. |
| Incorrect route of administration | Synvisc-One needs only be administered in the knee. You should always consult your healthcare provider for proper administration of Synvisc-One. Synvisc-One has not been tested to show pain relief if administered in other joints apart from the knee. |
| Drug interaction | Topical benzalkonium chloride and cetylpyridinium are known to interact with Synvisc-One. These drugs may prevent Synvisc-One injection from working properly. |
What to do if Synvisc-One does not work?
In case Synvisc-One is not working for you or you feel side effects are affecting your quality of life, you may ask your doctor for other possible clinical interventions.
Talk to your doctor
If Synvisc-One is not working for you and you feel that your symptoms are the same even after prolonged use, talk to your doctor. You should discuss your condition with the doctor, including adherence to Synvisc-One and dosing frequency.
Your doctor will identify possible reasons as to why Synvisc-One is not working. Open communication with your doctor about lifestyle factors such as drug abuse is important. Alternatively, your doctor may explore alternative options for you.
Alternatives to Synvisc-One
Synvisc-One can be alternated with intra-articular corticosteroid injections. Corticosteroids have a quicker onset of action but a shorter duration as compared to Synvisc-One. It is often used as an adjunct therapy for the relief of moderate to severe pain (4).
Alternatively, your doctor may prescribe intraarticular platelet-rich plasma injections instead of Synvisc-One. These injections are known to reduce osteoarthritic pain while improving knee mobility and knee function (4).
As a pharmacist, I would advise you to follow the directions of your doctor for the safe and effective use of Synvisc-One. Do not try to inject Synvisc-One yourself. If you experience pain, swelling, or redness at the injection site, inform your doctor.
You may take acetaminophen (a nonsteroidal anti-inflammatory drug) with Synvisc-One for symptomatic relief of osteoarthritis pain (5). You can also use diclofenac gel, available as 1% w/v Voltaren gel or Aleve arthritis gel.
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References
1.-
Kuropatkin GV, Ahtyamov IF, Stanislav ML, Kushnir VA, Belenkiy IG, Kopenkin SS, Tamazyan VO, Vezikova NN, Klyuchevskiy VV. Evaluation of safety and efficacy of Hylan GF 20 (Synvisc-One®) in patients with knee osteoarthritis in clinical practice. NN Priorov Journal of Traumatology and Orthopedics. 2020 Oct 8;27(2):36-44. https://journals.eco-vector.com/0869-8678/article/view/34192
2.-
Sun SF, Hsu CW, Lin HS, Liou IH, Chen YH, Hung CL. Comparison of single intra-articular injection of novel hyaluronan (HYA-JOINT Plus) with synvisc-one for knee osteoarthritis: a Randomized, Controlled, Double-Blind Trial of Efficacy and Safety. JBJS. 2017 Mar 15;99(6):462-71. https://journals.lww.com/jbjsjournal/FullText/2017/03150/Comparison_of_Single_Intra_Articular_Injection_of.3.aspx
3.-
Kocak D, Annaswamy T, Chong S, Arora R. Development of systemic inflammatory polyarthritis after zygapophyseal joint injection with hylan GF 20 (synvisc-one). American Journal of Physical Medicine & Rehabilitation. 2018 Feb 1;97(2):147-9. https://journals.lww.com/ajpmr/fulltext/2018/02000/Development_of_Systemic_Inflammatory_Polyarthritis.13.aspx
4.-
Ayhan E, Kesmezacar H, Akgun I. Intraarticular injections (corticosteroid, hyaluronic acid, platelet rich plasma) for the knee osteoarthritis. World journal of orthopedics. 2014 Jul 7;5(3):351. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4095029
5.-
Euppayo T, Punyapornwithaya V, Chomdej S, Ongchai S, Nganvongpanit K. Effects of hyaluronic acid combined with anti-inflammatory drugs compared with hyaluronic acid alone, in clinical trials and experiments in osteoarthritis: a systematic review and meta-analysis. BMC Musculoskeletal Disorders. 2017 Dec;18:1-4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5585914/
