New Osteoarthritis Drug May Require Fewer Injections

A new osteoarthritis drug developed by Novartis could offer long-term pain relief while reducing the frequency of injections.

Osteoarthritis is the most common type of arthritis, a degenerative joint disease affecting about 32.5 million Americans. The condition causes joint pain, stiffness, and swelling, mostly in the knees, but can also impact the hands, hips, and back.

The condition is characterized by the breakdown of cartilage, a protective tissue that enables nearly frictionless joint motion.

Current treatments of osteoarthritis focus on symptom management rather than the underlying cartilage breakdown and require frequent administration. For example, analgesics like acetaminophen (Tylenol) and nonsteroidal anti-inflammatory drugs (Advil) provide short-term pain relief.

Cortisone shots — steroid injections — work by decreasing inflammation and can alleviate pain for a few weeks. Lubrication injections with hyaluronic acid provide some cushioning in the knee and must be repeated every week for three to five weeks in a row to achieve pain reduction for about six months.

Additionally, patients may find relief from physical therapy and weight loss, as obesity is the greatest modifiable risk factor for the condition. Eventual joint failure requires surgical joint replacement, which may be a lifelong solution.

A new drug may be underway

Swiss pharmaceutical company Novartis has filed a US patent application for its novel knee osteoarthritis drug.

The medication includes a novel active ingredient, modified human ANGPTL3 polypeptide, and is injected into a joint in doses of 20 mg or 40 mg. Patients may need between one to three doses once a month for three consecutive months to achieve therapeutic effects lasting from six months to one year.

However, a patent application does not guarantee that the drug will enter the market, as all new medications must undergo rigorous efficacy and safety assessment.

Novartis did not respond to Healthnews’ request for comment on when the drug is expected to reach pharmacy shelves.

The focus on symptom relief

Tuhina Neogi, MD, PhD, chief of rheumatology at Boston Medical Center, says that drugs that address cartilage degradation could potentially revolutionize osteoarthritis treatment. However, limiting cartilage degradation would also need to be accompanied by symptomatic benefits.

Neogi says regulatory agencies are interested in seeing structural benefits tied to symptom benefits, such as how a patient feels, functions, and survives.

The challenge is that limiting cartilage degradation may not necessarily be accompanied contemporaneously with symptomatic benefit – the symptom benefit may appear later as the untreated arm continues to progress over time, while the treated arm remains stable, for example.

Neogi

Hope for cartilage regeneration

At the same time, scientists are exploring other medications that could prevent cartilage breakdown. Early research in animal models suggests that teriparatide (Forteo), a drug approved by the Food and Drug Administration to increase bone mass, may not only stop cartilage loss but also regenerate it.

StemJEL, a patented osteoarthritis drug which is being developed by Columbia University researchers, includes sclerostin, a growth factor in the niche of cartilage cells important for protecting joints. Formulated into an injectable hydrogel therapy, sclerostin was shown to restore joint function in animal models.

The new knee osteoarthritis drug by Novartis could provide pain relief with fewer injections and lead to cartilage regeneration. However, more studies are needed to test its safety and effectiveness.