One-minute jab that eases knee pain for three months
TINY balls filled with steroids could provide a long-lasting form of pain relief for arthritic knees. The microscopic spheres are injected into the knee, where their coating slowly dissolves, gradually releasing the steroids inside them.
now the treatment, which takes just one minute to administer and has been shown to provide relief for three months, is being tested in larger clinical trials, involving more than 700 people. Researchers say the jabs would not only provide longer-lasting relief than existing treatments, but also that patients could avoid side-effects associated with taking oral drugs.
Osteoarthritis is characterised by damage in and around the joint, as a result of the cartilage wearing out, causing pain and inflammation. The damage can trigger bony growths or spurs to develop around the edge of the joints, which then interfere with movement.
Arthritis Research UK estimates that more than half-a-million men and women have moderate to severe osteoarthritis of the knee — more than twice as many as have arthritis of the hips. A number of factors can increase the risk, including previous injury, advancing age (most patients are over 45) and obesity, which puts extra pressure on joints.
Painkillers such as paracetamol and ibuprofen taken orally or as rub-on creams or gels are one of the mainstays of treatment.
However, the active ingredients are released immediately into the body, which means they may stop being effective within hours or days.
Opioid painkillers, such as codeine, can help to relieve severe pain, but these can also potentially cause side- STEROIDS,effects including drowsiness, nausea and constipation. or corticosteroids to give them their medical name, are also used — either as tablets or injections. They can be effective at controlling pain, however the injections may sometimes cause facial flushing or interfere with the menstrual cycle. Other side- effects include skin thinning and mood changes.
The new treatment, known to the medical world as FX006, consists of a steroid called triamcinolone acetonide, which is packed into microspheres that are injected into the knee. The spheres are coated in a biodegradable compound, which breaks down once inside the body.
Research suggests that when a steroid is released in this way, it remains in the joint, which means the effects last longer. And as the drug does not circulate round the rest of the body, it reduces the risk of unwanted side-effects.
A study at the University of Sydney showed the drug remains in the joint fluid for 12 weeks, compared with just a matter of hours for some oral tablets. The developers, Flexion
JANE Therapeutics, are running a number of further trials in the U.S. TADMAN, of Arthritis Research UK, says: ‘doctors have been injecting steroids into joints to reduce pain for years. However, what’s novel and interesting about this approach is not the drug itself, but the way it is being delivered. We’re investigating similar ways of doing this in rheumatoid arthritis.
‘One of the benefits of this method of drug delivery is that it could avoid the side- effects associated with existing painkillers.
‘There is a massive need for more effective, side-effect-free painkillers for the millions of people in the UK with arthritis who are living in chronic pain with little relief available.’
MEANWHILE, injections of patients’ own fat are being tested as a way of repairing the tissue damage caused by knee arthritis.
In a trial at the Biosolutions Clinical Research Center in the U.S., 100 patients with knee arthritis will undergo liposuction, where fat will be removed and then processed in the laboratory.
Stem cells taken from the fat will then be injected into the knees.
exactly how it could work is not clear, but one theory is that, once in place, the stem cells develop and repair the tissue damage that occurs in the arthritic joint.