Fomulation of Malaysian Tualang Honey for intraarticular injection in osteoarthritis

Abstract

Current pharmacological treatments for osteoarthritis (OA) are analgesics and viscosupplements such as intraarticular injection of hyaluronic acid (IAHA). It has viscoelastic property similar to the synovial fluid, which is a viscous lubricant during walking and an elastic shock absorber during running. Honey, an established antioxidant, with highly viscous liquid texture may help in lubricating the ligament and neutralizing free radicals causing the disease. The objective of this thesis was to develop the appropriate formulation of Malaysian Tualang honey (MTH) that is comparable to IAHA in terms of its viscoelastic properties for intraarticular injection. Honey is a Newtonian fluid and does not exhibit viscoelastic property. Therefore, different concentration of carbopol, which acted as rheological modifiers, was added in combination to MTH and the rheological behaviours were measured using ThermoHaake rheometer. The viscosity and dynamic rheology of the various formulated MTH was analyzed and compared to IAHA and osteoarthritic synovial fluids. The latter was obtained from consented patients undergoing total knee arthroplasty. The rheogram constructed showed that synovial fluid, Synvisc and Suplasyn exhibited non-Newtonian shear thinning (pseudoplastic) fluid behaviour. The storage modulus of Synvisc and synovial fluid was more prominent than the loss modulus compared to Suplasyn. Higher concentration of carbopol led to higher viscoelastic property of the formulation. 1% carbopol neutralized with 2% triethanolamine (buffer) has the most comparable results to Synvisc and the formulation was later sterilized by gamma radiation. The viscoelasticity of the formulation was reduced post gamma irradiation, however the reduction of the viscoelasticity within post gamma irradiated formulation was not significant (p<0.05). It is concluded that MTH can be formulated into an alternative treatment and act as a viscosupplement in OA patients.