Euflexxa vs Orthovisc​: Comparing Efficacy, Duration & Cost​​ 

Knee osteoarthritis (OA) is a common degenerative joint disease affecting millions worldwide, leading to chronic pain, stiffness, and decreased mobility. Today, many patients who have not achieved proper relief through conservative therapies such as NSAIDs, weight loss, or physical therapy turn to viscosupplementation with intra-articular hyaluronic acid (HA) injections. This type of treatment can offer meaningful symptom relief, and the most commonly used products include Euflexxa and ORTHOVISC®, both FDA-approved for use in knee osteoarthritis. 

This article provides a detailed, side-by-side comparison of Euflexxa and ORTHOVISC® to assist clinicians in selecting the most appropriate therapy and to help patients understand their options based on clinical performance, safety, duration of effect, and cost.

Euflexxa vs Orthovisc: Overview of Both Products

Both Euflexxa and ORTHOVISC® are FDA-approved for the treatment of knee osteoarthritis in patients who did not manage to ease the symptoms through non-pharmacologic therapy and simple analgesics. However, healthcare professionals and patients can make the right choice only if they learn about the basic facts about each of the two products: 

What Is Euflexxa?

Euflexxa is a bioengineered, non-avian hyaluronic acid made via bacterial fermentation. It consists of 1% sodium hyaluronate in a phosphate-buffered saline solution. The treatment is administered in a series of three weekly injections. Due to its non-animal origin, it is an ideal solution for patients who are sensitive to avian protein. 

Key Facts About ORTHOVISC®

ORTHOVISC® is also a non-animal stabilised hyaluronic acid (NASHA) product. It contains 1% sodium hyaluronate, and it is made of high-molecular-weight hyaluronan, which is a naturally occurring substance in the synovial joint fluid. ORTHOVISC® contains one of the highest concentrations of HA among the viscosupplements available on the market. 

Mechanism of Action

Although Euflexxa and ORTHOVISC® have differences in composition, their mechanisms of action are quite similar, and this is usually the case with other hyluronic acid viscosupplement products. All in all, whether you compare only these two or you decide to go further and explore the differences between Monovisc vs Orthovisc, you will immediately see that all of them have the same goal, and that is to provide symptomatic relief to individuals suffering from knee osteoarthritis. 

How Do They Actually Work?

In knee osteoarthritis, the synovial fluid in the joints wears and tears down, which causes pain, friction, and inflammation. Both Euflexxa and ORTHOVISC knee injections are directly administered into the affected joint to supplement the remaining synovial fluid with hyaluronic acid, which is its primary aid when it comes to joint cushioning and lubrication. The formulations of ORTHOVISC® and Euflexxa mimic the activity of natural hyaluronic acid, which normally acts as a lubricant and absorbs shock when injected properly. They supplement the HA in the synovial fluid, and by lubricating the joints, they also prevent them from rubbing together, minimising pain and inflammation. 

By enhancing joint lubrication, these products can reduce pain and stiffness, potentially slowing the progression of joint degeneration and improving mobility. It is important to note that neither product modifies the underlying disease process but provides symptomatic relief.

Efficacy Comparison

Both Euflexxa and ORTHOVISC® have demonstrated clinical efficacy in randomised controlled trials. The outcomes are generally similar across multiple factors:

• Pain relief: Both products lead to statistically significant reductions in pain, with many patients reporting improvement after the second or third injection.
• Functional improvement: Improved joint function and reduced stiffness are common benefits, particularly in patients with mild to moderate osteoarthritis.
• Patient satisfaction: Surveys suggest that patients report similar satisfaction levels with both Euflexxa and ORTHOVISC®.

Particular Studies

Even though the number of clinical trials is quite limited, there are several examples where ORTHOVISC® demonstrates its efficacy. For instance, a controlled trial conducted by Neustadt et al. (2005) proves that the injection’s high molecular weight is safe and effective when it comes to mild to severe cases of knee osteoarthritis. The study gathered 372 participants, and 76% of them reported a significant improvement in the pain scores after eight weeks when compared to the 62% of control patients. 

When it comes to Euflexxxa, there were several clinical trials that compared its efficacy to other similar treatments. For instance, during a 12-week trial, Euflexxa brought significant pain relief to patients. In fact, 62% of participants reported being pain-free after the third injection, while two-thirds of them were entirely pain-free at the end of the study. 

Duration of Effects

Symptom relief with both Euflexxa and ORTHOVISC knee injections typically begins after the second injection, with full therapeutic effect observed within weeks of completing the three-dose regimen.

The duration of relief for both products generally extends up to six months, although it can vary depending on individual factors such as: 

• Age: Younger patients may experience longer-lasting effects.
• Severity of osteoarthritis: Patients with early or moderate disease symptoms frequently respond better to treatment.
• Activity level: Higher levels of activity may lead to a shorter duration of effect due to increased joint stress.

Cost Comparison

Cost is a major consideration, especially for uninsured patients or those with high-deductible plans. Also, the pricing can fluctuate depending on region, distributor, and insurance coverage. Fortunately for medical professionals, they can conveniently order Orthovisc or buy orthopedic injections wholesale at the Best Buy Fillers online store.

In some cases, Euflexxa may turn out to have slightly higher upfront costs, but the difference is generally modest. Insurance reimbursement may differ depending on payer agreements. It is also worth noting that while both require three injections, some clinicians find ORTHOVISC® easier to store and administer, which can influence purchasing decisions.

Overall, the value for cost is comparable when factoring in the frequency of injections and the potential duration of symptom relief.

Safety and Side Effects

Euflexxa and ORTHOVISC® are generally well tolerated, with low rates of adverse reactions. Most side effects are mild and temporary, including:

• Injection site pain
• Joint swelling or stiffness
• Local warmth or erythema

Serious complications that happen rarely include:

• Pseudosepsis: A sterile, inflammatory reaction causing acute joint swelling and discomfort (resolves with supportive care).
• Infection: Although rare with proper aseptic technique, septic arthritis is a possible complication.

As both products are non-avian, they are safe for patients with egg or bird protein allergies, which can be a concern with some older-generation HA injections.

When to Choose One Over the Other

In clinical practice, the choice between Euflexxa and ORTHOVISC® may come down to detailed factors rather than specific superiority. Whether you are a medical professional or a patient, consider the following:

• Patient sensitivity: Both products are suitable for avian-allergic individuals.
• Previous response: Patients who responded well to one brand in the past often benefit from continued use.
• Clinic familiarity: Providers may prefer one product based on experience, handling logistics, and inventory management.
• Insurance formularies: In some systems, one product may be preferred or more easily reimbursed.

Conclusion

Euflexxa and ORTHOVISC® are both reliable, evidence-supported options for treating knee osteoarthritis in patients who have exhausted conservative treatment options. They offer similar mechanisms of action, safety profiles, and efficacy timelines.

The choice between them should be individualised based on patient characteristics, cost considerations, previous treatment history, and provider experience. Even though none of them stops the progression of osteoarthritis, they can significantly reduce the existing symptoms and delay the need for surgical intervention

References: 

McElheny K, Toresdahl B, Ling D, Mages K, Asif I. Comparative Effectiveness of Alternative Dosing Regimens of Hyaluronic Acid Injections for Knee Osteoarthritis: A Systematic Review. Sports Health: A Multidisciplinary Approach. 2019;11(5):461-466.

Legré-Boyer V. Viscosupplementation: Techniques, indications, results. Orthopaedics & Traumatology: Surgery & Research. 2015;101(1, Supplement):S101-S108.

Neustadt D, Caldwell J, Bell M, Wade J, Gimbel J.: 10 Personal non-commercial use only. The Journal of Rheumatology www.jrheum.org Downloaded on. The Journal of Rheumatology. 1928;32.

McKenna A. Clinical and cost outcomes from different hyaluronic acid treatments in patients with knee osteoarthritis: evidence from a US health plan claims database – Drugs in Context. Drugs in Context. Published June 23, 2016.