New drug offers hope in osteoarthritis

A retrospective analysis of a large osteoarthritis (OA) trial has shown that the interleukin-1beta (IL-1β) inhibitor, canakinumab, can significantly reduce the need for total hip/knee replacement (THR/TKR).

The study, published in Annals of Internal Medicine, involved 10 061 participants receiving placebo or canakinumab (50, 150, or 300 mg) subcutaneously once every three months.

Median follow-up was 3.7 years. The incidence rates for THR and TKR were 0.31 and 0.54 events per 100 person-years (hazard ratio [HR], 0.58 [CI, 0.42 to 0.80]; p= 0.001) for the pooled canakinumab dose groups compared to placebo.

Because the trial was not originally designed to examine the efficacy of IL-1β inhibitors in OA, information on structural joint outcomes was not collected.

OA is a common inflammatory disorder with no disease-modifying therapies. An editorial in the same issue of the journal comments that the trial presents intriguing results that may offer promise for IL-1 inhibition as a treatment for OA. Further studies should evaluate the importance of elevated CRP levels as a factor affecting response to treatment, and to include more women to better reflect the osteoarthritis population, it says.

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