Biochemical analysis of rheumatoid synovial fluid after serial intra-articular injection of high molecular weight sodium hyaluronate.

A high-molecular-weight sodium hyaluronate (commercial name Artz) was serially injected biweekly for 12 weeks into 9 knee joints from 8 patients with active rheumatoid arthritis (RA) and certain clinical and biochemical parameters were monitored. Three of these parameters, namely specific viscosity, concentration of HA, and stringency, were significantly increased by the intra-articular injection of Artz. Clinically, the majority of the knees (7 out of 9 injected) showed a relief from pain and no joint fluid could be drawn from 4 of the knees after 12 weeks following the initial injection. Both the fluid volume collected and the molecular weight of hyaluronate in the synovial fluid showed some improvement, but it was not statistically significant. No improvement of systemic inflammatory parameters such as erythrocyte sedimentation rate and C reactive protein were observed. Injectable Artz sodium hyaluronate was effective for the treatment of local inflammation in RA.