Billy Wade

NOLTREX™ is a synthetic implant based on three-dimensional polyacrylamide cross-linked polymer with silver ions added. It helps to alleviate the symptoms of osteoarthritis, such as mild or severe pain, joint stiffness.

A disposable syringe of NOLTREX™ contains 2.5 ml of gel to be administered into the joint cavity.

Unlike other products commonly used in intra-articular injections, NOLTREX™ does not contain hyaluronic acid or other substances susceptible to degradation under the influence of enzymes contained in the human body, which ensures its long presence in the injection site.

NOLTREX™ is a biocompatible material, that has neither immunogenic, nor antigenic properties, it does not cause allergic reaction due to its synthetic nature.

Given the complexity and the irreversibility of the processes occurring in the joints of patients with osteoarthritis, the physician should make a choice of treatment which is not only safe, but also effective. This is necessary to achieve maximum stabilization of the pathological process and prevent secondary changes in the joint. The preservation of the joint functions and the maximum reduction of the impact of the disease on the patient’s life quality depend on the effectiveness of the treatment.

There is a misconception that the use of hyaluronic acid-based products is preferable as opposed to fully synthetic preparations. Claims are often made that the preparations based on hyaluronic acid are similar in composition to the human synovial fluid. However, the trouble is that the resemblance is not absolute, which is exactly what reduces their effectiveness in terms of quality. The preparations manufactured from animal raw materials are easily detected by immune cells of the body (phagocytes), destroyed and removed from the body. Besides, the use of animal raw materials often provokes allergic reactions and inflammations in the joint. Besides, the high speed of resorption accounts for a very short recommended interval between repeated injections.

The injections of NOLTREX™ should be repeated not more often than every six months - 1.5 years.1 This is accounted for by the macromolecules of the cross-linked polymer, which are virtually invisible for phags and eliminated from the body very slowly, enabling to maximize the length of therapeutic effect. Due to synthetic origin of the preparation allergic reactions to it are rare. For long history of its therapeutic use no allergic reactions have been reported.

Thus, there is an obvious answer to the question of choice of the treatment of osteoarthritis. At the moment NOLTREX™ is the absolute leader among the medical devices for the treatment of arthritis in terms of effectiveness and safety.

Inert macromolecules of NOLTREX™ do not react with body tissues. Over the years, the researches of polyacrylamides, a group of substances on which NOLTREX™ material is based, have shown that they are highly biocompatible with human tissues, exceptionally hypoallergenic and do not have any adverse impact on the vital functions of the patient’s body.2-6

Possible side-effects and complications are related to its administration (intra-articular injection) and include: pain or swelling at the site of injection, infections (septic arthritis, osteomyelitis, sepsis, etc.), neuropathies, embolia cutis medicamentosa, aseptic acute arthritis, joint effusion, bursting sensation, burning sensation, arthralgia, granuloma.

Some of these complications of intra-articular injections in general can be avoided thorough asepsis and careful administration technique. Some of the complications reported in the studies and in the post-marketing surveillance are explained by non-compliance with the precautions and contraindications (e.g. injection into a joint with synovitis). Periprocedural or temporary postproce-dural (not exceeding 72 hours) pain or burning sensation was the most common reported complication.

The most common complication (burning sensation, pain) can be managed well with non-steroidal anti-inflammatory analgesics. As NOLTREX™ does not contain any material of animal origin, the chance of allergic reactions is very low, although not impossible: no allergic reactions or rejections were reported neither in the clinical studies nor during the post-marketing surveillance.

Elizabeth Quay

Address: The Esplanade, Perth WA 6000, Australia

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