Skiöldebrand E, Adepu S, Lützelschwab C, Nyström S, Lindahl A, Abrahamsson-Aurell K, Hansson E
Department of Biomedical Sciences and Veterinary Public Health, Swedish University of Agricultural Sciences, Uppsala, Sweden.
Department of Clinical Chemistry and Transfusion Medicine, Institute of Biomedicine, Sahlgrenska University Hospital, Gothenburg University, Gothenburg, Sweden.
Osteoarthr Cartil Open. 2023 Jun 16;5(3):100381. doi: 10.1016/j.ocarto.2023.100381. eCollection 2023 Sep.
This study aimed to test a novel treatment combination (TC) (equivalent to sildenafil, mepivacaine, and glucose) with disease-modifying properties compared to Celestone® bifas® (CB) in a randomized triple-blinded phase III clinical study in horses with mild osteoarthritis (OA). Joint biomarkers (reflecting the articular cartilage and subchondral bone remodelling) and clinical lameness were used as readouts to evaluate the treatment efficacy.
Twenty horses with OA-associated lameness in the carpal joint were included in the study and received either TC ( 10) or CB ( 10) drug intra-articularly-twice in the middle carpal joint with an interval of 2 weeks (visit 1 & 2). Clinical lameness was assessed both objectively (Lameness locator) and subjectively (visually). Synovial fluid and serum were sampled for quantification of the extracellular matrix (ECM) neo-epitope joint biomarkers represented by biglycan (BGN) and cartilage oligomeric matrix protein (COMP). Another two weeks later clinical lameness was recorded, and serum was collected for biomarkers analysis. The overall health status was compared pre and post-intervention by interviewing the trainer.
Post-intervention, SF BGN levels significantly declined in TC () and COMP levels significantly increased in CB (). The flexion test scores improved in the TC compared to CB () and also had an improved trotting gait quality (). No adverse events were reported.
This is the first clinical study presenting companion diagnostics assisting in identifying OA phenotype and evaluating the efficacy and safety of a novel disease-modifying osteoarthritic drug.
本研究旨在通过一项针对轻度骨关节炎(OA)马匹的随机三盲III期临床研究,测试一种具有疾病改善特性的新型治疗组合(TC)(等同于西地那非、甲哌卡因和葡萄糖),并与倍他米松二丙酸酯(CB)进行比较。关节生物标志物(反映关节软骨和软骨下骨重塑)和临床跛行被用作评估治疗效果的读数。
本研究纳入了20匹腕关节与OA相关跛行的马匹,在腕中关节内分别接受TC(10匹)或CB(10匹)药物注射,间隔2周注射两次(第1次和第2次就诊)。临床跛行通过客观(跛行定位仪)和主观(视觉)评估。采集滑液和血清,用于定量由双糖链蛋白聚糖(BGN)和软骨寡聚基质蛋白(COMP)代表的细胞外基质(ECM)新表位关节生物标志物。另外两周后记录临床跛行情况,并采集血清进行生物标志物分析。通过与训练师面谈比较干预前后的整体健康状况。
干预后,TC组滑液BGN水平显著下降,CB组COMP水平显著升高。与CB组相比,TC组的屈曲试验评分有所改善(),小跑步态质量也有所提高()。未报告不良事件。
这是第一项展示伴随诊断有助于识别OA表型并评估新型疾病改善性骨关节炎药物疗效和安全性的临床研究。