Supplementary Appendix: Global Register of Commercial and Clinically Used Hyaluronic Acid Products
Márcio Hiroaki Kume¹*, Bianca Furlan², Camila Gobatto Boaventura², Mônica Andréa Probst², Edson Peracchi² and Carmen Austrália Paredes Marcondes Ribas3
¹Sugisawa Hospital, Department of Regenerative Medicine, Curitiba, Brazil
²CeUnina, Department of Biologic Science, Curitiba, Brazil
3Mackenzie University, Curitiba, Brazil
*Corresponding author: Márcio Hiroaki Kume, Sugisawa Hospital, Department of Regenerative Medicine, Curitiba, Brazil
Citation: Kume MH, Furlan B, Boaventura CG, Probst MA, Peracchi E, et al. Supplementary Appendix: Global Register of Commercial and Clinically Used Hyaluronic Acid Products. J Clin Pract Med Case Rep. 3(1):1-53.
Received: September 10, 2026 | Published: October 22, 2026
Copyright© 2026 Genesis Pub by Kume MH, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC BY 4.0). This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author(s) and source are properly credited.
DOI: https://doi.org/10.52793/JCPMCR.2026.3(2)-42
Introduction
S1. Purpose and scope
This appendix is the product-literacy companion to the main review. It registers 149 named hyaluronic acid (HA) products, product families and presentations that the main article's tables do not cover in full, across fifteen application categories, from intra-articular viscosupplementation and aesthetic injectables to ophthalmic viscosurgical devices, wound care, urology, gynaecology, bulking agents, adhesion barriers, ear-nose-and-throat and dental products, and cartilage-repair scaffolds.
Its purpose is descriptive and comparative, not promotional. Brand names appear so that clinicians, reviewers and regulators can identify what was actually studied, at what concentration, molecular weight, architecture and dose, in which jurisdiction, at what price, and on what strength of human evidence. No product listed here is endorsed, and no listing implies that a product is interchangeable with any other.
S2. How to read these tables
Every substantive cell carries a hyperlink to the exact primary document that states the value — a regulator record (premarket-approval summary of safety and effectiveness data, 510(k) summary, recall record), a manufacturer instruction for use, summary of product characteristics or European Union summary of safety and clinical performance, an official reimbursement file, or a peer-reviewed publication. Where a field could not be confirmed from such a document it is entered as n.a. and was not inferred, estimated or carried over from a comparable product.
Column key: Conc/dose = concentration and total HA per unit. MW = average molecular weight as disclosed. Evidence = the strongest product-specific human evidence identified, with level: I = randomised controlled trial or meta-analysis of randomised trials; II = comparative or prospective controlled study; III = observational study or case series; IV = laboratory, bench or regulatory data only. Cells describing "class-level" or "platform" evidence indicate that the cited data belong to a related product of the same platform, not to the presentation named in that row.
Price taxonomy: All prices are in United States dollars with the type, unit, pack size, geography and date stated:
- [ASP]: official payer payment limit or reimbursement basic price (United States Medicare Part B payment-limit file; United Kingdom NHS Drug Tariff Part IX basic price). A reimbursement limit is not an acquisition price.
- [ASP-calc]: a course cost calculated from a payment limit and the labelled regimen.
- [DIST]: distributor or wholesale list, sale or outlet price.
- [CASH]: consumer retail, pharmacy or discount-card price.
- [PATIENT]: patient-facing, direct-pay or clinic-aggregated average price.
Prices of different types are not comparable with one another, move continuously, and are not evidence of comparative clinical effectiveness. Amounts originally quoted in euro or pound sterling were converted at European Central Bank reference rates for 8 September 2026 (1 EUR = 1.1614 USD; 1 GBP = 1.35456 USD, derived from the published EUR/GBP rate of 0.85740), with the original currency and rate date retained in the cell.
S3. Evidence-integrity classification
Each row is classified by what its evidence supports, using four mutually exclusive labels:
|
Label |
Meaning |
What the label permits |
What it forbids |
|
PU — Platform utility |
Mechanical, rheological, barrier, lubricating, space-maintaining, bulking or carrier function, sometimes with randomised evidence for a clinical outcome |
Statements about the physical or protective function achieved, and about clinical endpoints actually measured |
Any implication of tissue regeneration, cartilage restoration or disease modification |
|
SV — Symptomatic / viscosupplementation |
Pain or function improvement over weeks to months, product-specific were stated |
Symptomatic benefit for the specific product, site and regimen studied |
Structural or chondroprotective claims; extrapolation of one brand's trial to another brand |
|
VB — Volumisation / biostimulation |
Volume, contour, wrinkle-severity, hydration or skin-quality improvement on validated aesthetic scales |
Correction and duration as measured on the stated scale |
Neocollagenesis, dermal "regeneration" or bone mimicry as demonstrated human structural restoration |
|
DR — Demonstrated regeneration |
Durable, controlled restoration of tissue architecture and function in humans |
— |
— |
No product in this appendix qualifies for the DR label: The three closest candidates are cartilage-repair scaffolds (Appendix Table S15): for the most widely marketed device the comparative evidence is non-randomised and the pivotal randomised trial is reported as mixed; for the second the randomised trial has 24 participants and a composite polyglycolic-acid/hyaluronan scaffold, so HA-specific attribution is impossible; and for the third the United States regulator's own review states that evidence was lacking. Demonstrated regeneration is therefore recorded as unestablished for every product listed here, including products marketed with regenerative or biostimulatory language.
One finding deserves emphasis because it tests the biostimulation claim directly: the only study in this register that measured a genuine structural endpoint after intramucosal injection of a cross-linked HA marketed for bio-stimulation found total vaginal mucosal thickness unchanged (213.65 versus 212.33; p = 0.5949) (Appendix Table S10).
S4. Product register by application category
Fifteen tables follow, in the order below. Row counts are the number of products, product-family or presentation entries in each table; a single row may cover several named presentations of one platform where the primary document treats them together.
|
Appendix table |
Application category |
Rows |
|
S1 |
Intra-articular viscosupplements for large joints |
41 |
|
S2 |
Small-joint, temporomandibular, post-arthroscopy and tendon or soft-tissue products |
7 |
|
S3 |
Aesthetic injectables newly approved in the United States (2021–2026) |
8 |
|
S4 |
Aesthetic fillers marketed outside the United States |
26 |
|
S5 |
Skin boosters, bioremodelling and hybrid injectables |
4 |
|
S6 |
Ophthalmic viscosurgical devices |
19 |
|
S7 |
Topical ophthalmic products: tear substitutes and eye ointments |
13 |
|
S8 |
Wound care and dermatological topical products |
6 |
|
S9 |
Urology: intravesical instillations |
6 |
|
S10 |
Gynaecology, vulvovaginal health and intrauterine adhesion prevention |
7 |
|
S11 |
Anorectal and urologic bulking agents |
3 |
|
S12 |
Surgical adhesion barriers |
2 |
|
S13 |
Ear, nose and throat, sinonasal and middle-ear products |
3 |
|
S14 |
Dental and periodontal products |
1 |
|
S15 |
Cartilage repair and orthobiologic scaffolds or composites |
3 |
|
Total |
|
149 |
Appendix Table S1. Intra-articular Viscosupplements for large joints
For Table view in Pdf
Appendix Table S2. Small-joint, temporomandibular, post-arthroscopy and tendon or soft-tissue products
For Table view in Pdf
Appendix Table S3. Aesthetic injectables newly approved in the United States (2021-2026)
For Table view in Pdf
Appendix Table S4. Aesthetic fillers marketed outside the United States
For Table view in Pdf
Appendix Table S5. Skin boosters, bioremodelling and hybrid (HA plus non-HA) injectables
For Table view in Pdf
Appendix Table S6. Ophthalmic viscosurgical devices
All are US class III devices under product code LZP (regulatory classification). HA source, where stated, is bacterial fermentation except where rooster comb is specified. Class for every row: PU (platform utility — intraocular tissue protection and space maintenance); DR unestablished.
Appendix Table S7. Topical ophthalmic products: tear substitutes and eye ointments
Class for every row: PU (ocular-surface lubrication/hydration); DR unestablished. All NHS prices are Drug Tariff Part IX basic prices for September 2026, converted at 1 GBP = 1.35456 USD (ECB, 8 September 2026).
Appendix Table S8. Wound care and dermatological topical products
For Table view in Pdf
Appendix Table S9. Urology: intravesical instillations
Class for every row: PU (glycosaminoglycan-layer replacement); DR unestablished.
Appendix Table S10. Gynaecology, vulvovaginal health and intrauterine adhesion prevention
For Table view in Pdf
Appendix Table S11. Anorectal and urologic bulking agents built on stabilised HA
For Table view in Pdf
Appendix Table S12. Surgical adhesion barriers
For Table view in Pdf
Appendix Table S13. Ear, nose and throat, sinonasal and middle-ear products
For Table view in Pdf
Appendix Table S14. Dental and periodontal products
For Table view in Pdf
Appendix Table S15. Cartilage repair and orthobiologic scaffolds or composites
For Table view in Pdf
S5. Alias, duplicate and exclusion register
The following names are not separate products and must not be counted, cited or compared as such. This register exists because trade-name proliferation is the single largest source of double counting in the HA literature.
|
Name |
Determination |
|
Sinovial 0.8% |
Alias of the FDA-approved Gelsyn-3 device (both covered by premarket approval P110005) (openFDA premarket-approval record; comparative review) |
|
Intragel, Intragel Mini, Jointex, Jointex Starter, Jointex Mini, Yaral, Yaral Forte, Yaral Mini, Gony Alert MD, Sinovial Mini |
Trade-name variants of one platform described in a single European Union summary of safety and clinical performance; cite once as an alias family (SSCP) |
|
Hyalart, Hyalectin |
Historical trade names of the Hyalgan platform (joint-by-joint brand review) |
|
Artz, Artzal as "United States products" |
Historical United States brand names of the Supartz / Supartz FX platform (product-level evidence review) |
|
Durolane SJ |
Small-joint presentation of the Durolane stabilised-HA platform, not a distinct formulation (instructions-for-use comparison) |
|
GenVisc 850 versus Adant |
Same formulation family; the United States device was approved on equivalence to the Supartz platform of which Adant is the European original (product-level evidence review) |
|
RHA Dynamic Volume |
Rename of the RHA 4 mepivacaine formulation with an added indication, not a new molecule (panel-track supplement summary) |
|
Juvéderm ULTRA 2 / 3 / 4, ULTRA SMILE |
European numbering of the Juvéderm Ultra family already tabulated in the main article (openFDA premarket-approval records) |
|
TotalVisc, DuoVisc, Healon Duet PRO / PRO II |
Co-packages of already-listed ophthalmic viscosurgical devices, not distinct formulations (StableVisc/TotalVisc summary; formulary review) |
|
Hylaform, Hylaform Plus, Captique, Prevelle Silk, Hydrelle/Elevess, Juvéderm 24 HV / 30 / 30 HV |
Legacy or discontinued United States fillers appearing only in historical premarket-approval trade-name records (openFDA premarket-approval records) |
|
Cellugel, OcuCoat |
Hydroxypropylmethylcellulose ophthalmic viscosurgical devices — not hyaluronic acid (formulary review) |
|
Gepan Instill |
Chondroitin-sulfate-only bladder instillation — not a hyaluronic acid product (Drug Tariff Part IX) |
|
Tactoset as an "HA therapy" |
Hyaluronic acid is an excipient in a settable calcium-phosphate bone substitute; listed only as a platform-utility example (510(k) summary) |
S6. Documented conflicts between sources
Conflicts are preserved rather than reconciled, because merging incompatible values would create a specification that no document supports.
|
Item |
Conflict |
|
Fermathron S |
A comparative review and the manufacturer brochure differ on cross-linking status and molecular weight; both values are shown in Appendix Table S1 with their own sources |
|
Euflexxa molecular weight |
Published as 24,000–3,600 kDa in one comparative review and 2,400–3,600 kDa in others; the lower range is arithmetically coherent, but the discrepancy is recorded rather than silently corrected |
|
Kartilage Cross |
Named as a cross-linked product yet listed as non-cross-linked in the instructions-for-use comparison |
|
Stylage range |
Concentrations printed in mg/dL in one source and mg/mL in others; only the source's own unit is reproduced |
S7. Coverage, limitations and how this appendix should be used
This register is broad but not exhaustive, and it is not a systematic review. Products enter it only when at least one primary document states their identity and specifications; several additional brands encountered in secondary or commercial listings were excluded because no qualifying primary document could be obtained, and their absence here is not evidence that they do not exist or do not work. Specifications for products marketed outside the United States derive from labels, summaries of product characteristics and regulatory summaries rather than from independent measurement. Prices are point-in-time values of differing type and vintage, and currency conversions rest on a single day's reference rate.
Used correctly, the appendix supports three tasks: identifying the exact product behind a published result; checking whether a marketing claim matches the evidence class its own documentation supports; and comparing prices only within a single price type. Used incorrectly — as a ranking, a formulary or a claim of equivalence between rows — it would reproduce the conflation this work exists to prevent.
Genesis Scientific Publication is licensed under CC BY-NC-ND 4.0
