GCs have been suggested as an independent risk factor for cardiovascular diseases. Wei et al . [ 25 ], using a record linkage database, compared GC users to non-users, most of them with IBD or chronic obstructive pulmonary disease. They found that doses > mg/day significantly increased the risk for myocardial infarction and cerebrovascular events. Of note, the association between GC use and cardiovascular events remained after adjustment for traditional cardiovascular risk factors [ 25 ]. A recent systematic review showed a poor association between cardiovascular risk and long-term prednisone-equivalent doses up to 10 mg/day. The authors found an increase in insulin resistance but no effects on the lipid profile or blood pressure. However, they found a trend of increasing risk of major cardiovascular events with exposure to such doses. This trend persisted even after adjustment on RA severity, activity or comorbidities [ 26 ].
ORTHOVISC ® and MONOVISC ® High Molecular Weight Hyaluronan are contraindicated in patients with known hypersensitivity to hyaluronate formulations or known hypersensitivity (allergy) to gram positive bacterial proteins. ORTHOVISC ® and MONOVISC ® High Molecular Weight Hyaluronan should not be injected in patients with infections or skin diseases in the area of the injection site or joint. MONOVISC ® High Molecular Weight Hyaluronan should not be administered to patients with known bleeding disorders. Intra-articular injection of sodium hyaluronate preparations has occasionally been associated with allergic/anaphylactic reactions and transient hypotension, which have generally resolved spontaneously or after conservative treatment.