Osteoporosis Drug might help Repair Joints-In Mice…

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osteoporosis drug for knee cartilage
New £10-a-day jab gives hope to millions of arthritis patients?

This was the headline that popped up on my Google search this morning under “Cartilage Repair”. It sounds like for just 10 pounds a day (roughly $15) this new drug can help you rebuild the cartilage in your knees. Wow! The new drug is called Forteo and is usually used to help build strong bones in osteoporosis patients (approved for use in Europe). When I read more of the article on the osteoporosis drug for knee cartilage, the drug helped rebuild cartilage in knees by 37%! Double wow! Regrettably, once I actually pulled the scientific paper behind the PR press releases it turns out that all of this was shown in mice with acute cartilage injury. Chronic degenerative knee arthritis in humans regrettably is a night and day different “animal” than what was treated in this experiment. Meaning an experiment where you injure a young mouse’s knee cartilage and then use a drug is not like treating the classic elderly patient with a 15 year history of knee arthritis. One piece of good news is that this drug isn’t the older style bisposphonate type used for osteoporosis that was associated with so many serious side effects, but instead acts through the parathyroid hormone system. What makes the study finding a little less “breakthrough” is the fact that lots of things have been shown to date to prompt knee cartilage repair (stem cells, BMP’s (bone morphogenic proteins), and a host of other growth factors including TGF-beta, PDGF, FGF, and IGF. In addition, the $15 a day listed in the headline is misleading as it sounds like this is a $15 shot one can pick up at a local pharmacy. In fact Forteo is injected once a month at a cost of $450 or about $5500 a year. Finally, the shot is given under the skin, so nobody knows how the drug would impact normal bone if given in patients with arthritis and without osteoporosis. The upshot? The mechanism of how the drug impacts cartilage cells in the mouse knee is encouraging, but this mouse finding is so badly hyped, that I almost believed for a moment that there were people walking around in Europe jabbing their knees for $15 a day and rebuilding cartilage! Nope, instead there’s just little mice on tiny crutches in a lab somewhere in upstate New York…

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