journal article·2026-07-24

Healing Response to Hyaluronic Acid Supplemented with Selected Amino Acids: A Pooled Analysis of Two Clinical Studies

Tiziana Ruggiero, Marta Bezzi, Ettore Cogno, Davide Camisassa, Renato Pol, Francesco Erovigni, Giorgio Reggiardo, Vincenzo Nobile, Paolo Giacomo Arduino

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Abstract

Background/Objectives: Diabetes is associated with impaired wound healing, with consequences for tissue recovery across surgical procedures. In the oral context, hyaluronic acid-based adjunctive therapies have shown promise in improving early post-extraction healing in diabetes; however, clinical evidence remains limited. Different supplemented HA-based formulations yield heterogenous healing outcomes. Moreover, whether age or diabetes duration influences the effect of these adjunctive therapies remains to be established. Methods: We conducted an individual-participant-data pooled analysis of two randomized controlled trials that evaluated the use of hyaluronic acid supplemented with two different sets of selected amino acids; individual data from each trial was combined into a single dataset. Results: In this pooled analysis, modified healing index scores improved significantly over time. When each intervention was evaluated relative to its corresponding control, hyaluronic acid plus six pro-collagen synthesis amino acids produced a significantly greater improvement in healing response over time than the other HA-based formulation, after adjustment for age (Greenhouse–Geisser: time × treatment: F = 5.821, p < 0.001) and diabetes duration (Greenhouse–Geisser: time × treatment: F = 4.939, p < 0.001). Neither age nor diabetes duration significantly modified the healing trajectory (Greenhouse–Geisser: time × age: F = 2.536, p = 0.083; time × diabetes duration: F = 0.131, p = 0.878). No clear association with age or diabetes duration was observed. Conclusions: Supplementing hyaluronic acid with six selected amino acids associated with a significantly faster post-extraction tissue recovery in patients with diabetes. Moreover, treatment choice was relevant regardless of age or years since diabetes diagnosis.
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Affiliations

Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Via Nizza 230, 10126 Turin, TO, Italy

Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Corso Duca degli Abruzzi 24, 10129 Turin, TO, Italy

Department of Biostatistics, Clinical Validation from Biopharmaceutical Findings (CVBF), Viale Cesare Battisti 17, 27100 Pavia, PV, Italy

Research & Development Department, Complife Italia S.r.l., Via Indipendenza 11, 27100 Pavia, PV, Italy

Funding

Professional Dietetics S.p.A

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