The availability of new drugs is less than could have been supposed at the beginning of this century. We continue with many limitations when it comes to being able to treat the main origin of the pathology that is the degeneration of the cartilage and bone involvement. Most of the drugs developed help deal with the consequences. That is why the ABT-981 drug has raised a certain interest with hopeful results in studies in American and European scientific groups.
The ABT-981 drug (Lukitizumab) is an immunomodular (monoclonal antibody) injected into the joint blocking the formation of interleukin (interleukin 1 alpha and beta) at the level of the joints. It has been seen as one of the important factors in the progression of chondropathy (cartilage degeneration). Studies in Phase-III, one of them in Madrid, are being developed, which will allow us to see its usefulness in the treatment of osteoarthritis (initially in the hip and knee).
The reality of the last studies is that if it is good to reduce the pain (probably because of its mechanism of action it decreases the inflammation of the joint), it is not being seen that it modifies the progression of the disease nor helps to regenerate the cartilage, which should be the two main goals as a drug.
The problem in the development of these drugs is basically economic. In the first place, there is a lack of resources to develop studies with more impact (know well the side effects), longer duration (arthrosis is a progressive pathology over time) and more pathologies (lumbar spine, hands, rheumatoid arthritis, …) , secondly, its cost would be very high given that it is a biotech drug (an antibody) and thirdly, the financing of its consumption would be limited to treat a non-vital pathology and with a huge presence in society, which would make indiscriminate financing destabilize the current system of public financing of drugs.
The main study to date is Fleischmann 1 (Dallas, September 2017) on 350 patients involving different countries, including a group from La Coruña (Spain). The study only has one year of follow-up, improves pain and functionality but nothing more (neither thickness of the cartilage, nor episodes of synovitis, nor other structural objectives).In conclusion: it is soon, it still has benefits to demonstrate, the side effects are unknown (the main currently is neutropenia), it will be expensive (it is part of those known as biological drugs), I see more indication in other articular pathologies (arthritis rheumatoid, …) and I do not think it will be in pharmacies before 2 years (2020), if it arrives …
1. Roy Fleischmann, Henning Bliddal, Francisco J Blanco et al .: “Safety and Efficacy of ABT-981, an Anti-Interleukin-1α / β Dual Variable Domain (DVD) Immunoglobulin, in Subjects with Knee Osteoarthritis: Results from the Randomized , Double-Blind, Placebo-Controlled, Parallel-Group Phase 2 Trial “. Meeting: 2017 ACR / ARHP Annual Meeting Date of first publication: September 18, 2017.
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