Learn MORE about the PHYSIOLOGY of ARTHRITIS

No local or systemic side effects have been observed pursuant to LEGEND® Injectable Solution injection in clinical field trials. Several post-approval adverse reactions have been reported, however:

• Occasional depression, lethargy, and fever have been observed following intravenous use.
• Lameness, joint effusion, injection site swelling and joint pain have been reported following intraarticular use.

The Role of Hyaluronic Acid (HA)

Hyaluronan or hyaluronic acid (HA) is a naturally occurring molecule that is present in the skin, connective tissue, vitreous humour (fluid within the eye) and the umbilical cord of mammals. High concentrations of HA are also found in synovial fluid, which is the primary lubricant of joints, tendon sheaths and bursas.

HA provides a multitude of benefits in the equine synovium:

• Increases the viscosity of synovial fluid, thereby enhancing its lubricating properties and visco-elastic effects.

• Regulates normal cellular constituents, thereby decreasing the impact of exudation, enzyme release and joint degradation in cases of synovitis/ arthritis.

• Inhibits the movement of granulocytes and macrophages, thereby impeding the development of inflammation (synovitis).

• Stimulates further endogenous HA production by the horse’s synoviocytes.

• Provides a physical barrier between inflammatory cells in the horse’s blood stream and the synovium.

• Decreases the interleukin-1-driven production and release of prostaglandin E2, which causes cartilage degradation.

• Scavenges oxygen-derived free radicals.

Hyaluronic acid is a glycosaminoglycan composed of repeating subunits of D-glucuronic acid and N-acetyl-D-glycosamine linked together by glycosidic bonds.

LEGEND® Preparation

Legend® Injectable Solution is prepared by extracting hyaluronic acid from the capsule of bacteria (Streptococcus spp), which contain HA comprising identical properties to that found in mammals. The extracted product is purified (through a 12-step microfiltration process) and sterilized, ridding it of protein and nucleic acids, which are known to increase the potential for post-treatment flares. The solution's pH is optimized for the equine synovial environment.

How Does LEGEND® Work?

Legend® works by decreasing the production and release of inflammatory mediators, thereby reducing associated pain and lameness.

How is LEGEND® Supplied?

Legend® is supplied in 2 mL (20 mg) vials for intraarticular use and 4 mL (40mg) vials for intravenous use. Each mL contains 10 mg hyaluronate sodium.

LEGEND� Injectable Solution is Supplied as the Following:

	Carton of six 2 mL (20 mg) vials for intraarticular (IA) use.
	Carton of six 4 mL (40 mg) bottles for intravenous (IV) use.
	Multi-Dose 20 mL bottles for intravenous (IV) use.

When Should You Use LEGEND®?

We recommend administering Legend® intravenously to performance horses 36-48 hours prior to a race, clinic, or show. The purpose of the medication is to maximize the performance of the horse for a selected event. The duration of clinical effect is about 2 weeks on average, even though the physiologic effect can last up to 45 days.

If regular short-term treatment (such as an IV dose of Legend® administered every 2-4 weeks or sooner) is required to produce and/or maintain soundness or does not result in a satisfactory response, then local arthrotherapy (i.e. joint injection) may be considered.

Learn more about Legend® Injectable Solution HERE.