Drug-free treatment may ease osteoarthritis pain

Published on 10 April 2013
Drug-free treatment may ease osteoarthritis pain

A new drug-free treatment called Flexiseq could be effective at treating osteoarthritis pain, new research suggests.

Scientists conducted a 12-week clinical trial involving the topical treatment, an aqueous gel packed with nano-sized spheres called Sequessome vesicles that in turn are filled with phospholipids, similar to those found in the lubricating synovial fluid in joints.

When the gel is applied, the Sequessome vesicles travel through the skin and accumulate on the surfaces of damaged cartilage, creating a layer of lubricating phospholipids and helping to ease the person's joint pain.

The recent phase-III trial involving Flexiseq, published in the journal Rheumatology, was originally designed to compare a different investigational treatment with the non-steroidal anti-inflammatory drug (NSAID) celecoxib.

While the investigational drug was deemed to be a failure, the researchers noticed that topical Flexiseq - which was used as a control therapy in the trial - actually produced similar results to celecoxib and was better tolerated by patients.

The trial involved 1,300 patients and found that those who applied Flexiseq twice a day typically benefited from a 39.8 per cent reduction in pain, compared with a 40.4 per cent improvement for those taking oral celecoxib.

This suggests that patients who use the novel treatment may benefit from a similar degree of pain relief as those taking celecoxib, but without the associated gastrointestinal risks.

Lead study author Professor Philip Conaghan said: "Most people with osteoarthritis live with chronic pain that interferes with their daily activities. Many can't take or can't tolerate current oral analgesics because of side-effects.

"There is therefore a huge unmet need for effective and safe analgesics for osteoarthritis. The new study is interesting because it suggests that a novel topical therapy, that doesn't include a topical anti-inflammatory drug, may help osteoarthritis pain (and mobility)".

Study co-author Professor Wolfgang Bolten noted that the topical treatment did not interact with any other drug therapies, as it does not contain an active pharmaceutical ingredient.

"Therefore the many elderly osteoarthritis patients with cardiovascular problems, in which NSAIDs are contraindicated, can be treated at low risk," he added.

A spokesman for Arthritis Research UK said: "Millions of people are living with the chronic pain caused by osteoarthritis which can affect every aspect of a person's life, and effective new treatments are desperately needed.

"It's well documented that a safer alternative to oral pain-relief medication such as NSAIDs are creams and gels applied directly to the painful joints. Some of the current oral NSAIDs prescribed to people with osteoarthritis have been associated with serious side-effects such as the increased risk of heart attacks, strokes and gastro-intestinal problems, so this new treatment may offer people at increased risk of these problems a safe and effective alternative form of pain relief.

"We now look forward to seeing the results of the further long-term effects of this gel from future trials."