I’m happy to report there have been a number of exciting developments reported at the EULAR (European League Against Rheumatism) meetings in Barcelona this spring, several of which may be of interest to you.
1). Prexige and Osteoarthritis. This medication is a new generation COX-2 selective nonsteroidal anti-inflammatory, manufactured by Novartis. In one clinical study of almost 800 hypertensive patients with osteoarthritis aged 50 and older, Prexige taken once a day showed a significant difference in systolic blood pressure (stable) when compared to patients taking ibuprofen 600 mg three times a day (elevated). This medication is approved for treatment of hip and knee osteoarthritis in countries including the European Union, Canada and Latin America. Of note, this molecule provides 24 hours of pain relief and is structured differently than the other COX-2 selective nonsteroidals, lacking the sulfur molecule which has been associated with skin rashes in patients with sulfonamide allergy. Prexige is currently under review by the FDA.
2). Measuring Damage in Knee osteoarthritis. Standing knee films remain the most accurate diagnostic tool for assessing patients with knee osteoarthritis. In a published study presented at EULAR, 1,750 films of fully flexed, semi-flexed and extended knees were reviewed in an effort to assess which projection provided the most accurate look at joint space width (loss of which accurately predicts structural damage). The semi-flexed projection proved to be the most sensitive for reading structural changes with none in the knee, and is recommended for all patients undergoing radiographic study.
3). Gene Therapy in Osteoarthritic Mice. A research group at Rochester Medical Center (NY) studied a novel form of therapy to reduce painful joints in mice affected with osteoarthritis (a model system for studying human OA). Using a virus to inject genes coding for pain receptors on the surface of specific nerve cells, researchers found that cells injected in the osteoarthritic mouse jaw increased their number of opiate receptors a thousand-fold. Increased receptor numbers conferred increased sensitivity to medications delivered directly into the joint, with direct application for human disease. Gene therapy for human osteoarthritis may confer additional benefits to those not interested in joint replacement or reluctant to take oral medications for control of osteoarthritic pain.
