The benefit of adding N-acetyl glucosamine to ‘arthritis’ injections

the benefit of adding N-acetyl glucosamine to ‘arthritis’ injections

This article is sponsored content brought to you by Ceva.

If your clinic is regularly using a pentosan product to help with the management of osteoarthritis cases, you will be familiar with the benefit of using a disease-modifying osteoarthritis drug (DMOAD) as part of a multimodal approach. But you may not be aware that you could further improve clinical outcomes by switching your pentosan-only product for a pentosan product combined with N-acetyl glucosamine.

N-acetyl-glucosamine (NAG) is a more bioavailable form of glucosamine, which is the major building block of cartilage. The proven benefits are achieved by ensuring that efficacious levels of the highly bioavailable form of glucosamine (NAG) are present alongside high levels of pentosan polysulphate at the time of administration. 

How DMOADs work to improve the clinical signs of OA:

Pentosan polysulphate promotes active joint repair mechanisms in 5 ways1:

  •  Stimulates cartilage cells to produce proteoglycan, helping to restore damaged cartilage
  •  Stimulates hyaluronic acid production which improves joint fluid 
  •  Pentosan is a potent anti-inflammatory agent, helping to limit damaging inflammation
  •  Inhibits degradative enzymes: Limits ongoing damage 
  •  Pentosan has a short-lived anti-coagulant activity. This helps to improve blood flow to joints and supports healing.
  • N-acetyl glucosamine rebuilds by: 
  •  Providing the building blocks for cartilage repair and supporting the anti-inflammatory activity of pentosan to help speed up clinical response2.

Only SYNOVAN® combines pentosan polysulphate and N-acetyl glucosamine to provide the gold standard disease-modifying product for your osteoarthritic patients.

Results from a double-blinded, randomised study2 by Charles Sturt University showed that 

1. SYNOVAN reduced lameness by approximately 30% in just 2 weeks. A fast, significant reduction in lameness was seen with the pentosan + NAG combination compared to a gradual reduction seen with pentosan alone

2. SYNOVAN significantly reduced pain vs baseline from week 12.  Pain was reduced significantly compared to baseline; and significantly more than in the pentosan-only group between weeks 5-9

3. SYNOVAN mean overall improvement scores were significantly better (lower) compared with pentosan alone at Week 1 and Week 2

4. By Week 11, dogs using SYNOVAN recorded 60% further improvement in their mean overall improvement score vs Week 1.

The dosing interval and recommendations for SYNOVAN remain the same as for other pentosan products: one weekly injection for 4 weeks followed by regular reviews to assess the response to treatment. 

Improvement is often noted within 1-2 weeks after starting the course2 and a course of 4 injections provides relief for 3-6 months in most cases. It is recommended to repeat the full course at least every 12 months, with a treatment review at 3 months to consider if the course could be repeated at 3-6 months.

SYNOVAN does not need to be stored in the fridge, has a 3-month broach vial longevity and is dosed at 0.3ml/10kg.

Aside from using a gold-standard DMOAD, it is also important to consider the dog’s home environment. Small changes can improve patient welfare and quality of life significantly. Use of non-slip rugs or carpet tiles on slippery surfaces and stairs is important. Keeping the patient’s nails short allows them to utilise their paws correctly when standing up and can improve mobility from a prone position. The use of rubber toe grips may also improve an arthritic dog’s ability to move around unaided.

For further information on SYNOVAN, please contact your local Ceva territory manager or email 


1. SYNOVAN® Leaflet 

2. McConaghy FF et al. Comparison of efficacy of sodium pentosan polysulfate alone with combination of sodium pentosan polysulfate and N-acetyl glucosamine for treatment of osteoarthritis in dogs. Control & Therapy 2018;292:37-41. 

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