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La storia di Arthrosamid

The story of Arthrosamid began two decades ago. Born from an idea of the Contura team, the product was used on humans for various indications since 2000 and a positive safety profile had already been defined for it.

Arthrosamid: a treatment for osteoarthritis developed over 20 years

In April 2021, Arthrosamid received CE marking (European market approval) for the symptomatic treatment of patients with knee osteoarthritis (OA), following the completion of a prospective twelve-month open-label study that saw a significant reduction in pain in participants1,

The CE marking for Arthrosamid has been an important milestone for a product in development for over 20 years and addresses an unmet clinical need for effective, long-lasting, safe and minimally invasive treatment that can postpone and potentially prevent knee surgery for patients with OA.2 But what's behind the scenes of this new non-biodegradable hydrogel, which is now supposed to provide patients with OA with pain relief and improved mobility? 1,3,4

2000

L'idrogel è usato per indicazioni umane

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Arthroshamid's story began two decades ago, when Contura's patented hydrogel technology was used on humans. Contura had developed a number of hydrogel-based products and the experience of its safe application was consolidated with their use as an aesthetic volumizing agent, which in turn led to its use as a volumizing agent in treatments for women, such as in the case of stress urinary incontinence. The Contura team and its Chief Scientific Officer, Dr. Ankorina Stark, aware of the physical properties of their unique hydrogel, wanted to investigate what happens when the product is injected into the joints.

Beauty

2006

Inizia lo studio su conigli e vengono mostrati risultati positivi

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Contura's team of specialists began exploratory work on the joints of healthy rabbits in 2006. Initial doubts about its limited effect, due to the fact that the hydrogel could be "ground" inside the joint, turned out to be unfounded. In collaboration with one of Denmark's leading pathologists, Dr. Lise Christensen, the team found that the product fully integrated into the synovial membrane of the joints without adverse effects.5

Rabbit

2008

Il gatto Emile riceve trattamento con idrogel

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With the positive data obtained from the rabbit study, Dr. Ankorina Stark had the opportunity to test the hydrogel on another species, when she was presented with the case of the friend cat. Overweight and with a limited quality of life, the cat Emile evidently suffered from severe joint pain and reduced mobility.

Working with the veterinarian the team worked with on the rabbit study, Dr. Ankorina Stark oversaw Emile's treatment with the hydrogel in 2008. Within a few months and after just one injection, Emile was back on his feet and active, and he was a happy patient.

Around the same time, Dr. Ankorina Stark and her colleagues, led by Dr. Aziz Tnibar, initiated another experimental model on goats, which showed that the hydrogel appeared to halt the development of OA and improve joint elasticity.6

Cat

2009

Il primo cavallo viene curato - La zoppia scompare e arriva 4° in gara

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These results led the team to contact veterinarians with hydrogel samples. Initially, they made little progress, but the situation changed in 2009, when one of the veterinarians, Linus Camitz, injected the hydrogel into a horse that suffered from severe lameness in two joints and experienced such pain that its owner was thinking of having the animal culled. Two weeks after a single injection of hydrogel, the horse showed a 90% improvement in lameness and, a few weeks later, finished a race in fourth place, a result that had seemed impossible just a few months earlier.7 This opened doors, with other owners interested in trying this "life-saving" treatment on their horses.

At the same time, Contura was considering seeking human guidance for the product, but the company was aware of the need for more evidence of the hydrogel's potential benefits for joints. Given that horse joints have a similar configuration to those of humans, a study in horses seemed the most obvious route to follow and would have provided an opportunity to see the effects that the hydrogel had on the synovial membrane of the knees. The team then undertook a 24-month study on horses that gave them the results they needed: after just one injection, more than 80% of the horses no longer showed lameness.7 As a result, in 2009, Arthramid Vet, a long-acting intra-articular injectable drug for the treatment of equine and canine lameness, was launched.

Horse

2010

Il primo paziente umano riceve il trattamento con idrogel

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Behind the scenes, a state-of-the-art rheumatology specialist, Dr. Andreas Hatkopp, had undertaken a series of small pilot investigations at his clinic in Denmark, using the product in many of his patients destined for knee replacement surgery. He had achieved encouraging results3,4 And, in 2010, he was introduced by a veterinarian friend to one of the horse owners, who now suffered from severe joint pain himself. Having witnessed firsthand the positive benefits of the hydrogel, this patient was treated by Dr. Hatkopp and had an immediate improvement. Thanks to word of mouth dr. Hatkopp soon began treating a number of patients off-label, with positive results.3,4

Human

2018

Risultati riportati dopo il trattamento di oltre 80 pazienti in uno studio osservazionale di proof-of-concept (PoC)

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In parallelo, Contura ha continuato a condurre test dettagliati di biocompatibilità e al banco sull'idrogel e, nel 2018, uno studio osservazionale di proof-of-concept su oltre 80 pazienti trattati con Arthrosamid ha dimostrato che il sollievo iniziale dal dolore sintomatico è stato mantenuto per oltre un anno.3

Injection

2019

Contura avvia uno studio clinico multicentrico, randomizzato, controllato, in doppio cieco

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Questo studio è stato seguito da un'analisi retrospettiva di serie di casi che ha affrontato in modo specifico gli aspetti di sicurezza e i risultati hanno confermato che non è stato registrato alcun segnale di preoccupazione per la sicurezza.4 Nel 2019, Contura ha avviato uno studio clinico multicentrico, randomizzato, controllato, in doppio cieco di Arthrosamid in pazienti affetti da OA del ginocchio, su più di duecento persone in quattro centri di cura specialistici. Questo studio voleva confrontare la riduzione del dolore ottenuta in vari momenti nell'arco di un anno a seguito di una sola iniezione di Arthrosamid, con la riduzione del dolore ottenuta con una delle principali marche di acido ialuronico, un diverso trattamento di iniezione per la stessa indicazione. Anche in questo caso, i risultati per Arthrosamid sono stati positivi e i risultati di questo verranno pubblicati verso la fine del 2021.8

Sempre a settembre 2019, Contura ha condotto uno studio con l'obiettivo specifico di ottenere l'approvazione europea. È stata eseguita un'indagine clinica prospettica in aperto di Arthrosamid su 49 pazienti affetti da OA del ginocchio, presso tre centri di cura specialistici in Danimarca. Questo studio ha misurato la riduzione del dolore raggiunta a tre mesi, sei mesi e 12 mesi, dopo una sola iniezione di Arthrosamid. Rispecchiando i risultati del precedente studio osservazionale di proof-of-concept, i dati sono stati positivi: i pazienti trattati con Arthrosamid hanno sperimentato una significativa riduzione del dolore per oltre un anno.1

Doctors

2021

Ad aprile viene assegnato ad Arthrosamid il marcatura CE illimitata (approvazione per il mercato europeo) per il trattamento sintomatico di pazienti affetti da OA del ginocchio

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E così, nell'aprile 2021, dopo 10 anni di rigorosi test al banco, test di biocompatibilità e studi clinici - e due decenni dopo che è stata avanzata per la prima volta l'idea di studiare l'uso del prodotto per le articolazioni - Arthrosamid ha ottenuto l'approvazione europea per il trattamento sintomatico di pazienti affetti da OA del ginocchio.

Benché l'OA sia il tipo più comune di artrite e la causa di disabilità in più rapida crescita in tutto il mondo9,10, questo settore di trattamento ha visto pochi progressi negli ultimi 20 anni. Per il fatto che si sa ancora così poco su ciò che causa esattamente l'OA del ginocchio, una cura permanente è ancora tutta da scoprire. Di conseguenza, i trattamenti si sono concentrati sulla gestione dei sintomi della patologia, il che significa che le opzioni disponibili per coloro che vivono con OA sono limitate, fino ad ora.

Arthrosamid è un nuovo tipo di trattamento che offre ai pazienti un'alternativa efficace alle terapie disponibili. Arthrosamid offre sollievo prolungato con una sola iniezione, integrandosi nel tessuto sinoviale per creare un effetto simile a un cuscino che riduce il dolore e diminuisce la rigidità. Con il lancio di Arthrosamid, Contura mira a offrire sollievo dal dolore duraturo ai pazienti affetti da OA del ginocchio, migliorando la loro qualità di vita e aiutandoli a muoversi di nuovo.

CE M Ark

References

1. OARSI CONNECT 2021 POSTER 336 POLYACRYLAMIDE HYDROGEL INJECTION FOR KNEE OSTEOARTHRITIS: RESULTS OF A 52 WEEK PROSPECTIVE STUDY Henning Bliddal, Anders Overgaard, Andreas Hartkopp, Jannie Beier, Philip G Conaghan, Marius Henriksen.

2. Bliddal H, Overgaard A, Hartkopp A, Beier J, Conaghan PG, et al. (2021) Polyacrylamide Hydrogel Injection for Knee Osteoarthritis: A 6 Months Prospective Study. J Orthop Res Ther 6: 1188.

3. Henriksen M et al. Intra-articular 2.5% polyacrylamide hydrogel for the treatment of knee osteoarthritis: an observational proof-of-concept cohort study. Clin Exp Rheumatol. 2018;36(6):1082-5.

4. Overgaard A et al Safety of Intra-Articular Polyacrylamide Hydrogel for the Treatment of Knee Osteoarthritis Symptoms: A Retrospective Case Series. Clin Ortho (2019) Adv Res J: COARJ-100001.

5. Christensen, L., Daugaard, S., 2016. Histological Appearance of the Synovial Membrane after Treatment of Knee Osteoarthritis with Polyacrylamide Gel Injections: A Case Report. Journal of Arthritis 5, 217.

6. Tnibar A, Persson AB and Jensen HE. Mechanisms of Action of an Intraarticular 2.5% Polyacrylamide Hydrogel (Arthramid Vet) in a Goat Model of Osteoarthritis: Preliminary Observations. SM J Biomed Eng. 2017; 3(3): 1022

7. Tnibar, A., Schougaard, H., Koene, M., Christensen, L.H., Markussen, B., A controlled clinical trial on the efficacy of an intra-articular polyacrylamide hydrogel in horses with osteoarthritis. 23rd Annual Scientific Meeting of the European College of Veterinary Surgeons (ECVS), Copenhagen, July 2014.

8. A Multi-centre Randomized, Controlled, Double-blind Clinical Investigation of Intra-articular Polyacrylamide Hydrogel in Subjects With Knee Osteoarthritis Followed by an Open Label Extension Study.

9. Murray CJ, Vos T, Lozano R, et al. Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: a systematic analysis for the global burden of disease study 2010, Lancet, 2012, vol. 380 (pg. 2197-223).

10. Vos T, Flaxman AD, Naghavi M, et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: a systematic analysis for the global burden of disease study 2010, Lancet, 2012, vol. 380 (pg. 2163-96).