Home The Book Dr Articles Products Message Boards Journal Articles Search Our Surveys Surgery ESWT Dr Messages Find Good Drs video


Posted by Darlene on 7/23/04 at 15:02 (156137)

I have read with interest the information you have posted on hyaluronidase with respect to scar tissue.

Why do you think it isn't used more often?

How effective is it?



Re: hyaluronidase

Ed Davis, DPM on 7/24/04 at 11:10 (156197)

Hyaluronidase has been used very often. It was previously called by its trade name Wydase as it was manufactured by Wyeth Pharmaceuticals. They no longer produce it so it is somwhat harder to find. It is a substance made by our own bodies that has the responsibility of breaking down scar tisse but can be synthesized and concentrated. It is very effective.

Re: hyaluronidase - Dr. Ed

Terri on 7/24/04 at 15:31 (156202)

Why is Wyeth Pharmaceuticals no longer producing it? Is there a problem we should watch out for? I have an appt with my dr early next month and am planning on asking him if this would work for me as well.

Do most insurance companies cover the use or is it considered experimental?

I found this info on the web:

'Hyaluronidase (Wydase*) is a medical preparation of highly purified bovine testicular enzyme. The enzyme hydrolyzes hyaluronic acid, which usually limits diffusion by binding cells together. Thus, it is believed that hyaluronidase increases permeability and promotes the spread of local anesthetic. This accelerates the onset of akinesia, and also helps to reduce the increase in intraocular pressure that can be seen after peribulbar block. In 1986, hyaluronidase was reported in the literature to enhance the diffusion of ocular anesthesia, and since then, has been widely used in injections of local anesthesia for cataract surgery and other ophthalmic surgeries. In 1999, Wydase* was used in approximately 750,000 procedures.
In January 2001, Wyeth-Ayerst announced that it would not resume manufacturing Wydase*. The drug has been in limited supply since Wyeth-Ayerst voluntarily closed its manufacturing facility. Some Physicians are turning to compounding pharmacies to obtain hyaluronidase as an alternative to Wydase*'

Is it a human substance or bovine? What is a compounding pharmacy? If it is found to bind cells together, how then does it break up scar tissue?

Sorry for all the questions but it seems like answering one generates more.

Re: Compouding Pharmicist

Darlene on 7/24/04 at 17:58 (156210)

Compounding pharmicists are a great source of information. They custom make preparations based on a doctor's prescription. There are many compounding pharmicists in major cities. I go to the pharmicist for advice first, and then ask the doctor to write the prescription. I even have my local compounding pharmicist make up a natural moisterizer which I love and is much cheaper than branded products. I had some vitamin B6 made into a transdermal cream to see if it would help my foot (neuroma). Unfortunately it didn't.

Re: Dr. Ed

Darlene on 7/24/04 at 18:10 (156214)

Could hyaluronidase be used transdermally or does it have to be injected? I wonder if it would be effective in the early stages of neuroma development. I'm trying to figure out what to do about the 'fibrous proliferation but no well formed neuroma in the 2nd web space' according to my MRI.
What do you think - hyaluronidase or cortisone?
Ultrasound hasn't helped.



Re: hyaluronidase - risk of "mad cow" disease

HelenEC on 7/25/04 at 04:02 (156222)

Terri, from the timing and knowing that Wyeth's main manufacturing facility is in the UK I am guessing that Wyeth stopped production because of BSE (mad cow disease). In 2001, the first cases of new variant CJD (Creuzfeld-Jacob Disease - generally believed to be caused by the BSE prion) came to light in the UK. I guess Wyeth didn't bother to start up production again because the money they made on Wydase wasn't worth the risk of getting sued if they made a batch from a mad cow and gave a dozen people CJD.

If you are buying hyaluronidase in the US, you would run a small risk of contracting new variant CJD as the US has had cases of BSE. Hyaluronidase made from Australian or Irish cows would probably be OK as neither country has so far suffered cases of BSE, and their government's are quite determined that they won't in the future either.


Re: hyaluronidase - risk of "mad cow" disease

Terri on 7/25/04 at 11:21 (156229)

Helen, that's an interesting scenario and you may quite possibly be correct as to the reason they quit production. It's too bad that people are so upset about the possibility of contracting BSE they forget it is confined to the neurological system (brain and spinal cord)in cattle. In food processing there have been instances where cross-contamination occured resulting in human infection when it was ingested.

Re: hyaluronidase - risk of "mad cow" disease

Ed Davis, DPM on 7/26/04 at 09:34 (156255)

As far as we know, the virus does not live in a sterile solutions and there has never been a case transmitted via use of hyaluronidase.

Re: Dr. Ed

Ed Davis, DPM on 7/26/04 at 09:35 (156256)

An injectable combination of the two is probably the most efficacious.

Re: hyaluronidase - risk of "mad cow" disease

HelenEC on 7/26/04 at 16:11 (156285)

Hello Dr Ed.

Unfortunately the BSE prion - as it is not technically 'alive' - can survive in conditions that would kill a virus. I have no reason to believe anyone ever found BSE in Wydase, or that anyone has ever contracted NVCJD from hyaluronidase. Realistically, the risk must be vanishingly small. However, the UK did have a case where CJD was transmitted in human pituitary hormone from the donor cadaver to six other individuals, so the possibility, however small, does exist. The UK has also recently stopped accepting blood donations from individuals who have themselves received blood transfusion after 1980, because of the small but apparently statistically significant possibility that such individuals are themselves harbouring NVCJD.

It would appear it's nasty stuff, BSE


Re: Hyaluronidase Transdermal

4Mil on 8/13/09 at 20:02 (259688)

Darlene, did you ever determine if hyaluronidase can be used in transdermal delivery? I too am curious! 4Mil