CINGAL® is a highly effective preparation for the treatment of osteoarthritis. It combines the immediate anti-inflammatory and pain-relieving effect of the cortisone triamcinolone hexacetonide with the long-lasting effectiveness of cross-linked hyaluronic acid with a high active ingredient content for proven fast and long-lasting pain relief with just one injection.
THE FIRST MONO-THERAPY WITH A COMBINATION OF HYALURONIC ACID AND CORTISONE
CINGAL® is the first ready-to-use combination product offering dual efficacy. When injected into the affected area, the crystal suspension slowly dissolves, providing immediate pain relief. The combination with cross-linked hyaluronic acid with a high active ingredient content results in long-lasting pain relief for at least 6 months.
2 in 1 – combination preparations
- Unique combination of hyaluronic acid with patented crosslinking technology and the cortisone triamcinolone hexacetonide
- Fast and long-lasting pain relief
1+ Quality
- Cross-linked hyaluronic acid with high active ingredient content (88 mg)
- Biotechnological fermentation manufacturing process, free from animal proteins
A plus for patients
- Only 1 injection per treatment cycle
- Fast and long-lasting pain relief and improved joint mobility
- For anyone who wants fast results and doesn’t have time for repeated injections
CINGAL® is a highly effective preparation for the treatment of osteoarthritis. It combines the immediate anti-inflammatory and pain-relieving effect of the cortisone triamcinolone hexacetonide with the long-lasting effectiveness of cross-linked hyaluronic acid with a high active ingredient content for proven fast and long-lasting pain relief with just one injection.
The steroid triamcinolone hexacetonide has been used for decades as an intra-articular injection for persistent inflammation in the joint, such as arthritis or activated osteoarthritis. In the case of intra-articularly injected hyaluronic acid, the cross-linking of the molecules plays an important role. This slows down the enzymatic degradation of hyaluronic acid, thereby significantly prolonging its half-life in the joint.
Day 1 Month 1
Immediate effect Long-lasting effect
Fig. 1: Reduction in WOMAC pain score in % over the respective study period
Micronized particles of lipophilic cortisone are added as a particle suspension to the hydrophilic, viscoelastic hyaluronic acid gel. Neither the properties of hyaluronic acid nor those of cortisone are altered by combining them in the CINGAL® formulation.9 The combined mechanism of action of CINGAL® only takes effect when injected into the affected joint.
Fast and long-lasting effectiveness
CINGAL® is the first ready-to-use combination product offering dual efficacy. When injected into the affected area, the crystal suspension slowly dissolves, providing immediate pain relief. The combination with cross-linked hyaluronic acid with a high active ingredient content results in long-lasting pain relief for at least 6 months.8
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CINGAL® provides faster pain relief than hyaluronic acid without cortisone
CINGAL® works faster than cross-linked hyaluronic acid alone. A significant reduction in pain is evident in weeks 1 and 3.10
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Patients in the CINGAL® study confirm long-lasting pain relief
The course of pain reduction suggests that CINGAL® has a longer duration of action (significantly more than 26 weeks).10
CINGAL® is the first and only combination product that concentrates the treatment of activated osteoarthritis into a single injection.
Fig. 2: Reduction in WOMAC pain score in % over the respective study period
Hyaluronic Acid Active Ingredient Content: 88 mg
Triamcinolone Hexacetonide Active Ingredient Content: 18 mg
Therapy: 1 injection
Contents: 1 prefilled syringe (4 ml)
Manufacturing: Fermentation
Production: Boston, USA
Indications: Approved for the knee joint
Approval: Medical device with CE marking
Triamcinolone Hexacetonide Active Ingredient Content: 18 mg
Therapy: 1 injection
Contents: 1 prefilled syringe (4 ml)
Manufacturing: Fermentation
Production: Boston, USA
Indications: Approved for the knee joint
Approval: Medical device with CE marking
More knowledge, more movement
Osteoarthritis is the most common joint disease worldwide and refers to the wear and tear of the joints. The mobility of the joint decreases and the affected patient loses the ability to move freely. The joint becomes inflamed, swells and hurts. The joints most commonly affected are the hand, knee, and hip joints, as they are subjected to the greatest strain in everyday movement. In principle, however, any other joint can also be affected. In Germany, an estimated 8 to 10 million people are affected. From an economic perspective, osteoarthritis is the most significant disease of the musculoskeletal system.
While most people only experience occasional discomfort, around 2 million patients suffer from constant pain and severe mobility impairments. The number of people affected is set to rise in the coming years due to increasing life expectancy. But it is not only older people who are affected. Cartilage damage is becoming increasingly common in children and adolescents. In addition, there is a growing number of recreational athletes who participate in trendy and risky sports such as kitesurfing or downhill mountain biking. These sports put extreme strain on the joints, so that even younger people are increasingly experiencing arthritic symptoms.
As a group of active substances, cortisone performs numerous tasks in the metabolism and immune system. It slows down immune reactions and thus also acts against severe inflammation. Cortisone preparations suppress the misguided immune system and alleviate inflammation in the joints. In cases of inflammatory joint disease, they are injected directly into the joint in the form of crystal suspensions. Arthrosis patients with active arthrosis benefit from cortisone injections due to their anti-inflammatory effect and immediate pain relief, as the active ingredient quickly reaches the area where it is needed to combat the inflammation.
Triamcinolone hexacetonide injections have been used for over 45 years due to their anti-inflammatory and pain-relieving properties. They take effect quickly, but their effect is typically short-lived.
Triamcinolone has an anti-inflammatory effect that is five times stronger than the body’s own cortisol. The duration of action after injection into the joint is 3–4 weeks.
Hyaluronic acid is a naturally occurring biocompatible molecule that is present in the human body. It plays a key role in tissue and especially in the joints. The maximum effect of hyaluronic acid after intra-articular injection occurs after 4-8 weeks. The properties of hyaluronic acid are crucial to its effectiveness. Cross-linked hyaluronic acids achieve significantly better results than low-molecular, simple hyaluronic acids. Hyaluronic acid with a slightly cross-linked molecular structure is optimally tolerated and the stabilized hyaluronans remain in the joint longer.
