Biolevox™ HA ONE is a hyaluronic acid (HA) gel, especially designed for a single intra-articular injection in order to ameliorate symptoms of the osteoarthritis (OA) in synovial joint.

HA-based gel product contains 120 mg of hyaluronate in 4.8 mL pre-filled syringe. A unique combination of optimally high molecular weight and high concentration of hyaluronate in Biolevox™ HA ONE creates a gel characterized with optimally high viscosity and elasticity1. Thus, Biolevox™ HA ONE stands as an ideal solution for a single shot viscosupplementation therapy as it provides a very high dose of optimally high molecular hyaluronate in single injection.

As a result, upon the injection, Biolevox HA ONE is able to effectively lubricate cartilaginous surfaces and absorb the shocks that occur during movement of OA affected joint in which synovial fluid properties have been highly compromised2.

Unquestionably, Biolevox™ HA ONE due to its unique physicochemical properties is able to ameliorate OA symptoms like pain and joint mobility limitation and thus significantly improve OA patient’s quality of life3.
  1. Data on file Biovico
  2. Band PA, Heeter J, Wisniewski HG, Liublinska V, Pattanayak CW, Karia RJ, Stabler T, Balazs EA, Kraus VB. Hyaluronan molecular weight distribution is associated with the risk of knee osteoarthritis progression. Osteoarthritis Cartilage. 2015 Jan;23(1):70-6
  3. Data obtained based on the Biovico Clinical Program
Viscosupplementation, so intra-articular injection of HA, is scientifically and clinically approved practice for reducing joint pain, improving functional condition of OA-affected joint, finally delaying the progression of the disease1.
Importantly, treatment based on the single intra-articular injection of HA demonstrate a therapeutic effectiveness and significant improvement of the OA symptoms leading to recovery of patient’s quality of life2.

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Biolevox™ HA ONE contains a very high dose of 120 mg sodium hyaluronate in a single injection of 4.8 mL volume. The therapy is dedicated as an one injection because the gel in characterized with the optimal 2.5% concentration of hyaluronate that provides precisely selected viscosity, tailored in the range of 250-400 Pa*s. Hyaluronate contained in Biolevox™ HA ONE is characterized with optimally high molecular weight of molecules that stays in the range of 1.2 to 3.2 MDa.

HA-based gel with such a unique properties improves shock absorption and lubrication of the cartilaginous surfaces as well as reduces inflammation state due to appropriate biological response via CD44 receptors. Moreover, such content are particularly tailored for a single intra-articular HA treatment, providing long term clinical effect in OA patients3,4.

Therapy based on Biolevox™ HA ONE is perfectly safe as hyaluronan contained in the product is manufactured in fully controllable conditions by bacterial fermentation with use of Streptococcus sp. strain., providing the products that possess no possibility for uncontrolled tissue response upon the intra-articular injection3,5.

The administration of Biolevox™ HA ONE is recommended as single intra-articular therapy. Clinical data show that single intra-articular injection of hyaluronic acid gel with appropriately selected properties like one of Biolevox™ HA ONE is clinically effective in ameliorating OA symptoms for at least 6 months6.

Package of Biolevox™ HA ONE contains single pre-filled syringe of 4.8 ml

The product is meant to use by medical practitioners only.
  1. Hunter DJ. Viscosupplementation for Osteoarthritis of the Knee. Jarcho JA, ed. N Engl J Med. 2015;372(11):1040-1047. doi:10.1056/NEJMct1215534
  2. Hussain, S., Rather, H., & Qayoom, A. (2015). Efficacy, tolerability and adverse events of single-shot intra-articular hyaluronic acid injection in knee osteoarthritis. JMS SKIMS, 18(2), 128-133.
  3. Altman RD, Bedi A, Karlsson J, Sancheti P, Schemitsch E. Product Differences in Intra-articular Hyaluronic Acids for Osteoarthritis of the Knee. Am J Sports Med. 2016;44(8):2158-2165. doi:10.1177/0363546515609599
  4. Chevalier X, Jerosch J, Goupille P, et al. Single, intra-articular treatment with 6 ml hylan G-F 20 in patients with symptomatic primary osteoarthritis of the knee: a randomised, multicentre, double-blind, placebo controlled trial. Ann Rheum Dis. 2010;69(01):113-119.
  5. Mohammed AA, Niamah AK. Identification and antioxidant activity of hyaluronic acid extracted from local isolates of Streptococcus thermophilus. Materials Today: Proceedings. 2022;60:1523-1529.
  6. Bannuru RR, Natov NS, Dasi UR, Schmid CH, McAlindon TE. Therapeutic trajectory following intra-articular hyaluronic acid injection in knee osteoarthritis--meta-analysis. Osteoarthritis Cartilage. 2011 Jun;19(6):611-9.
Hyaluronic acid and viscosupplementation
Hyaluronic acid (HA) is one of the major constituent of articular cartilage extracellular matrix and synovial fluid1. HA is a biopolysacharide- it consists of a number of sugar molecules bonded together into a long chain1.

HA is a crucial structural component of synovial joint as it acts as a lubricant, shock absorber, filler and metabolic agent2. OA development diminishes lubricating and shock absorption abilities of synovial fluid mainly by degradation of naturally produced HA3.

Viscosupplementation, so intra-articular injection of HA, is scientifically and clinically approved practice for reducing joint pain, improving functional condition of OA-affected joint, protecting cartilage and finally delaying progression of the disease4.
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Viscosupplementation
Intra-articular injection of HA restores and maintains viscoelastic properties of synovial fluid, thus enables improved lubrication and reliefs pain5. HA exerts anti-inflammatory, analgesic and chondroprotective effects in synovial joints6. In long term, clinical benefits of viscosupplementation persist well beyond the intraarticular residence of HA since clinical benefits achieved by HA intra-articular injection occurs due to increase of naturally produced HA in synovial joint thus reestablishment of joint homeostasis3. In consequence, viscosupplementation can improve joint function, thus allow return to normal physical activity and improve patients quality of life7.

Importantly, many scientific comparisons and clinical investigations show that intra-articular HA injection is comprehensively safe, in contrast to steroid intra-articular injection that can lead to cartilage thinning and damage8.
HA intra-articular mechanism of action
  • HA restores viscoelastic properties of OA-affected synovial fluid thus improves lubrication
  • HA induces synthesis of natural hyaluronic acid thus contributes to recover of joint homeostasis9
  • HA binds to special receptors- CD44 on cartilage and synovial cells in order to support matrix production10 and inhibit inflammation
  • HA affects OA-related nerve oversensitivity and reduce hyperalgesia11
  • HA diminishes inflammatory processes by reduction of proinflammatory mediators production and action12
Only high molecular weight HA is fully biologically functional 
  • Only optimally high molecular weight HA possess the ability to protect against articular cartilage damage by restoring joint lubrication and joint homeostasis9
  • Only optimally high molecular weight HA is able to reduce OA-related pain13
  • Only HA with optimally high molecular weight HA is able to reduce OA-related inflammation processes14
  • Only optimally high molecular weight HA is able to protect articular cartilage from OA-related degenerative changes and show clinical benefits15
  1. Murray CJ, , Memish ZA. Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012 Dec 15;380(9859):2197-223
  2. Felson DT. Clinical practice. Osteoarthritis of the knee. N Engl J Med. 2006 Feb 23;354(8):841-8. doi: 10.1056/NEJMcp051726. Erratum in: N Engl J Med. 2006 Jun 8;354(23):2520.
  3. Balazs EA, Watson D, Duff IF, Roseman S. Hyaluronic acid in synovial fluid. I. Molecular parameters of hyaluronic acid in normal and arthritis human fluids. Arthritis Rheum. 1967 Aug;10(4):357-76.
  4. Creamer P, Sharif M, George E, Meadows K, Cushnaghan J, Shinmei M, Dieppe P. Intra-articular hyaluronic acid in osteoarthritis of the knee: an investigation into mechanisms of action. Osteoarthritis Cartilage. 1994 Jun;2(2):133-40.
  5. Ghosh P, Guidolin D. Potential mechanism of action of intra-articular hyaluronan therapy in osteoarthritis: are the effects molecular weight dependent? Semin Arthritis Rheum. 2002 Aug;32(1):10-37.
  6. Strauss EJ, Hart JA, Miller MD, Altman RD, Rosen JE. Hyaluronic acid viscosupplementation and osteoarthritis: current uses and future directions. Am J Sports Med. 2009 Aug;37(8):1636-44.
  7. Petrella RJ, Petrella M. A prospective, randomized, double-blind, placebo controlled study to evaluate the efficacy of intraarticular hyaluronic acid for osteoarthritis of the knee. J Rheumatol. 2006 May;33(5):951-6.
  8. McAlindon TE, LaValley MP, Harvey WF, Price LL, Driban JB, Zhang M, Ward RJ. Effect of Intra-articular Triamcinolone vs Saline on Knee Cartilage Volume and Pain in Patients With Knee Osteoarthritis: A Randomized Clinical Trial. JAMA. 2017 May 16;317(19):1967-1975.
  9. Smith MM, Ghosh P. The synthesis of hyaluronic acid by human synovial fibroblasts is influenced by the nature of the hyaluronate in the extracellular environment. Rheumatol Int. 1987;7(3):113-22.
  10. Chow G, Nietfeld JJ, Knudson CB, Knudson W. Antisense inhibition of chondrocyte CD44 expression leading to cartilage chondrolysis. Arthritis Rheum. 1998 Aug;41(8):1411-9.
  11. Pozo MA, Balazs EA, Belmonte C. Reduction of sensory responses to passive movements of inflamed knee joints by hylan, a hyaluronan derivative. Exp Brain Res. 1997 Aug;116(1):3-9.
  12. Takahashi K, Goomer RS, Harwood F, Kubo T, Hirasawa Y, Amiel D. The effects of hyaluronan on matrix metalloproteinase-3 (MMP-3), interleukin-1beta(IL-1beta), and tissue inhibitor of metalloproteinase-1 (TIMP-1) gene expression during the development of osteoarthritis. Osteoarthritis Cartilage. 1999 Mar;7(2):182-90.
  13. Gomis A, Pawlak M, Balazs EA, Schmidt RF, Belmonte C. Effects of different molecular weight elastoviscous hyaluronan solutions on articular nociceptive afferents. Arthritis Rheum. 2004 Jan;50(1):314-26.
  14. Gotoh S, Onaya J, Abe M, Miyazaki K, Hamai A, Horie K, Tokuyasu K. Effects of the molecular weight of hyaluronic acid and its action mechanisms on experimental joint pain in rats. Ann Rheum Dis. 1993 Nov;52(11):817-22.
  15. Altman RD, Bedi A, Karlsson J, Sancheti P, Schemitsch E. Product Differences in Intra-articular Hyaluronic Acids for Osteoarthritis of the Knee. Am J Sports Med. 2016;44(8):2158-2165. doi:10.1177/0363546515609599

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