Acute adverse reaction to hylan G‐F 20: Comment on the article by Martens

Evidence for interaction between disease severity and comorbidity in rheumatoid arthritis? comment on the article by Navarro‐Cano et al

“…Consistent with descriptions previously reported in the literature (1,2,(4)(5)(6)(7)(8), the reactions 1) generally occurred after at least 2 injections had been given, 2) occurred within 72 hours of an injection; 3) were similar to clinical findings in septic arthritis but with negative results on synovial fluid culture, an absence of crystals, and presence of elevated cellular infiltrate; and 4) generally required intervention. Based on a literature search (Medline, Toxline, EMBase, International Pharmaceutical Abstracts, and Biosis), Hyalgan has not been associated with reports of pseudoseptic reactions.…”

“…It would have been informative to add the recovered IgG antibodies for each studied mouse to determine the percentage of IgG accounted for by the tested antibodies. Of note is that in a recent study of kidneys from patients with systemic lupus erythematosus, the specificity of the majority of recovered IgG was also not established (2).…”

“…These results may be of particular interest in view of the finding of serum anti-GFAP antibodies in SLE patients (2). In fact, Sanna and coworkers showed a correlation between serum anti-GFAP antibodies and the neuropsychiatric disturbances in patients with SLE (2). We recently investigated the prevalence of anti-GFAP antibodies in 51 unselected SLE outpatients (44 women, 7 men; mean age 36.…”

“…A number of studies have demonstrated an association between extraarticular disease manifestations in RA and mortality (2)(3)(4). We recently studied the epidemiology of extraarticular disease in RA and its impact on survival in a study of a community-based RA cohort that extended over 46 years (5,6).…”

“…To the Editor: A report by Martens (1) and a comment on it by Gil et al (2) have added to the growing anecdotal evidence for a difference in safety profiles between available hyaluronan products such as Hyalgan (sodium hyaluronate; Fidia SpA, Padua, Italy) and Synvisc (hylan G-F 20; Genzyme Biosurgery, Ridgefield, NJ). Because there have been few head-to-head studies to aid in making a decision on the use of one product over the other, we undertook a prospective, controlled trial, approved by the local ethics committee, to evaluate the safety and efficacy of Hyalgan and Synvisc in knee osteoarthritis patients in an orthopedic practice.…”