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Dr Laurent Grange (Rheumatologist)
After several years of research, a new track could finally fight effectively against osteoarthritis of the knee. The molecule, called LNA043, would allow the regeneration of cartilage. A first trial on humans is conclusive.
Finally a beginning of an answer to fight against osteoarthritis? We can only hope so. This joint disease, which affects up to 10 million French people, unfortunately has no curative treatment to date. Only symptomatic treatments aimed at reducing pain (analgesics, anti-inflammatories or infiltrations) can now be offered to those who suffer from it (beyond the use of a knee prosthesis). But a study, recently published in the journal Nature could change that. It takes as subject the LNA 043 molecule identified by the Novartis laboratory, which would boost the repair properties of chondrocytes, cartilage cells to promote regeneration.
An encouraging phase 1 trial in knee osteoarthritis
The study mentioned retraces all the stages of research around this molecule, LNA043, a derivative of angio-poietin-like 3, the effect of which is discovered while thousands of molecules are being evaluated. Its role is tested for the first time in vitro, then in animals and finally in humans in a phase 1 trial:
28 patients with knee osteoarthritis awaiting a prosthesis received an intra-articular injection of LNA043 or placebo 2 hours, 7 days or 21 days before total knee arthroplasty. With a convincing result in these subjects with very advanced knee osteoarthritis.
“LNA043 promotes chondrogenesis and cartilage matrix synthesis in vitro and regenerates articular cartilage in preclinical models of osteoarthritis and cartilage damage in vivo” announces the study.
The advantage of having performed this injection before the operation, is that they were able to measure on the removed cartilage that the LNA043 molecule had an effect, according to the press release.
For the first time, an injection achieves a reconstitution of the cartilage
Contacted, Dr. Laurent Grange, rheumatologist and member of our committee of experts, explains to us why this discovery is important. “Each year, laboratories test hundreds of molecules in tubes, on different diseases. But for the first time, a molecule would have an anti-inflammatory effect that makes it possible to block certain pathways in the chondrocyte, the key cell of cartilage, which builds and destroys it. Concretely, this molecule acts by asking the chondrocyte to stop the destruction and promote the formation of good quality cartilage. he explains to us.
Hope for all those affected by knee osteoarthritis? “It’s very interesting, yes, it’s the first time that a molecule manages to reconstitute cartilage” recognizes the rheumatologist. However, it is better at this stage to remain cautious: “We have been very disappointed several times in the past, thinking of discovering the grail. This is currently only a study of 28 people. Is this the molecule of the future? To find out, we will have to wait for the results of phase 2, announced in 2027”.
The discovery, however, gives hope. As the rheumatologist reminds us, for those who suffer from it, the impact of osteoarthritis goes well beyond pain: the loss of function and difficulty in walking also significantly reduce life expectancy.