Cingal is a unique combination product that delivers strong results so patients with early to moderate osteoarthritis in the knee may once again enjoy daily physical activities with reduced pain. Cingal combines two well-established treatments in a single injection, providing the benefits of both an approved corticosteroid and a proprietary high concentration cross-linked hyaluronic acid formulation. Cingal is a simple treatment performed by a health care professional during an in-office visit.

Cingal is CE mark indicated as a viscoelastic supplement or a replacement for synovial fluid in human joints. Cingal is well suited for rapid and long term relief of the symptoms of human knee joint dysfunctions such as osteoarthritis. The actions of Cingal are long term relief of symptoms by lubrication and mechanical support supplemented by short-term pain relief provided by triamcinolone hexacetonide. Cingal is indicated for the treatment of pain in osteoarthritis (OA) of the knee in patients who have failed to respond adequately to conservative non-pharmacologic therapy and to simple analgesics (e.g. acetaminophen). Cingal includes an ancillary steroid to provide additional short term pain relief.

Cingal® is a unique single-injection treatment proven to safely and effectively treat the pain and certain symptoms associated with osteoarthritis (OA). Cingal combines a fast acting steroid with Anika’s proprietary cross-linked hyaluronic acid formulation in one single injection treatment to provide rapid pain relief that lasts.

• Cingal is injected through a sterile, disposable, hypodermic needle of suitable gauge into the knee joint space.
• The sterile needle should be attached to the Cingal syringe by a health care professional using health care facility approved aseptic technique.
• Recommended needle size for injections into the knee is 18-21 gauge. The final needle selection for any procedure is determined by the physician.
• The health care provider should ensure proper penetration into knee joint synovial space prior to injecting Cingal.

Contraindications

• Cingal is composed of cross-linked hyaluronic acid, triamcinolone hexacetonide, and inactive ingredients.
• The following pre-existing conditions may constitute relative or absolute contraindications to the use of Cingal:
  • Hypersensitivity to the active substance or to any of the excipients contained in Cingal
  • Pre-existing infections of the skin region of the intended injection site
  • Known infection of the index joint
  • Known systemic bleeding disorders
  • Weak populations including children and pregnant or lactating women
• The ancillary medicinal substance, triamcinolone hexacetonide, is contraindicated in the case of:
  • Active tuberculosis
  • Herpes simplex keratitis
  • Acute psychoses
  • Systemic mycoses and parasitoses (strongyloid infections)

After-care

• For some, pain relief happens almost immediately, while it may take a few days for others. In a clinical study, CINGAL patients experienced statistically significant reduction in knee pain in the first week.
• In a Cingal clinical study, significant knee pain relief was sustained through 6 months. Although there were no time points measured after 26 weeks, clinical results show that the effects of Cingal lasted and appeared to get stronger at 6 months, allowing patients to continue to experience maximum pain relief.
• The safety of receiving a repeat injection of Cingal was confirmed in a follow-up clinical study. In this study, patients received a second injection six months after their initial injection of Cingal. Repeated treatments can be performed as directed by a clinician.