Selection of hyaluronic acid for intra-articular administration in severe pain
Mubarakshina O.A., Dronova Yu.M., Zhdanova O.A., Batishcheva G.A., Peshekhonov D.V.
This article examines current understanding of the pathogenesis of osteoarthritis and the mechanisms underlying pain syndrome development under conditions of mechanical joint overload, inflammation, and progression of degenerative changes. The mechanisms of action of hyaluronic acid, which provide mechanical joint relief and have anti-inflammatory, chondroprotective, and analgesic effects, are analyzed. Clinical trial data and international guidelines confirming the efficacy and safety of intra-articular hyaluronic acid administration for osteoarthritis in various locations are presented. The importance of the physicochemical characteristics of hyaluronic acid, which determine its rheological properties, duration of action, and clinical efficacy, is examined.
A comparative analysis of the high-molecular intra-articular implants Flexotron® Plus and Flexotron® Magnum is conducted. It is shown that the products differ in sodium hyaluronate concentrations, which may determine the specifics of their clinical use. Flexotron® Plus may be a rational choice for patients with severe pain and functional impairment, while Flexotron® Magnum may be of greater interest for patients with pain associated with chondromalacia and articular cartilage damage, requiring more significant mechanical joint support.
For citations: Mubarakshina O.A., Dronova Yu.M., Zhdanova O.A., Batishcheva G.A., Peshekhonov D.V. Selection of hyaluronic acid for intra-articular administration in severe pain. Pharmateca. 2026;33(4):82-92. (In Russ.). DOI: https://dx.doi.org/10.18565/pharmateca.2026.4.82-92
Authors’ contribution: O.A. Mubarakshina – article concept. Yu.M. Dronova, O.A. Mubarakshina, D.V. Peshekhonov – collection and processing of materials. O.A. Mubarakshina, Yu.M. Dronova – data analysis and writing. O.A. Zhdanova, G.A. Batishcheva – scientific editing.
Conflicts of interest: The authors confirm that they have no conflicts of interest to declare.
Funding: The study was conducted without any sponsorship.
About the Authors
Olga A. Mubarakshina, Cand. Sci. (Med.), Associate Professor, Department of Clinical Pharmacology, Voronezh State Medical University named after N.N. Burdenko, Russia; mubarakshina@mail.ru, ORCID: https://orcid.org/0000-0001-6799-6322 (corresponding author)Yulia M. Dronova, Cand. Sci. (Med.), Associate Professor, Department of Clinical Pharmacology, Voronezh State Medical University named after
N.N. Burdenko, Russia; y.dronova@yandex.ru, ORCID: https://orcid.org/0000-0003-4513-091X
Olga A. Zhdanova, Dr. Sci. (Med.), Associate Professor, Professor at the Department of Clinical Pharmacology, Voronezh State Medical University named after N.N. Burdenko, Russia; olga.vr9@yandex.ru, ORCID: https://orcid.org/0000-0002-3917-0395
Galina A. Batishcheva, Dr. Sci. (Med.), Professor, Head of the Department of Clinical Pharmacology, Voronezh State Medical University named after N.N. Burdenko, Russia; bat13@mail.ru, ORCID: https://orcid.org/0000-0003-4771-7466
Dmitry V. Peshekhonov, Dr. Sci. (Med.), Rheumatologist, XXI Century Clinic, Voronezh, Russia; dmmad@yandex.ru, ORCID: https://orcid.org/0009-0003-2522-7586
