Erosion blockade breakthrough: Clinical trial signals hope for hand osteoarthritis (Available denosumab)

Medical Xpress / Ghent University / Nature Medicine ^ | Feb. 15, 2024 | Ruth Wittoek et al

[ConservativeMind]

Researchers show that antibody therapy can be effective against erosive hand osteoarthritis. Using the antibody denosumab leads to bone remodeling and the prevention of erosive joint damage. This is the first evidence that erosive progression can be halted in this disease.

While current therapies can alleviate symptoms, they do not address the structural damage in the affected hands.

Recent research, however, suggests that people with erosive hand arthritis have other issues as well. Overall, their bones are thinner and they lose bone and cartilage as the condition progresses, even in bones and joints that are not immediately affected by the osteoarthritis. In other words, rather than being a 'local' disease, erosive hand osteoarthritis is a 'systemic' bone condition.

Prof. Ruth Wittoek said, "The realization that we're dealing with a systemic disease prompted us to consider that we may need a treatment that is also systemic. The antibody denosumab is already used to treat osteoporosis and cancer-associated bone loss. Moreover, it was demonstrated that denosumab reduced erosive progression in rheumatoid arthritis."

To test the potential of denosumab, the researchers recruited 100 patients with erosive hand osteoarthritis, who were subsequently randomly divided into a treatment and a placebo group—a double-blind, randomized, placebo-controlled trial, which is the golden standard for interventional studies.

Over 48 weeks, the patients received injections of 60mg of denosumab or a placebo every three months. After that treatment period, the people receiving the antibody showed clear bone remodeling and fewer new joint erosions compared to the placebo group. Importantly, the antibody treatment did not lead to more adverse effects.

This study demonstrates that denosumab has positive effects on erosive hand osteoarthritis by bone remodeling and the prevention of joint erosions. This work also supports the concept that erosive hand osteoarthritis is a systemic disease that requires systemic treatment.

[ConservativeMind]

Denosumab is also known as Prolia and Xgeva.

The dose was given every three months and had no negative side effects, while remodeling bone and preventing further bone loss.

Osteoarthritis is actually an immune disorder, like rheumatoid arthritis, it appears.

[ConservativeMind]

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[smokingfrog]

There are potential side effects, as there usually are with any drug.