Knee Arthritis is a major problem in the United States. Its a problem because most americans are very active, many americans are over weight, and active overweight people put a lot of stress on their knees. As a result, the cartilage wears out (cartilage wear = arthritis).
The problem with cartilage wear is that cartilage doesnt grow back. Bone grows back, but cartilage is actually very delicate. Therefore, once the arthritis sets in, theres no going back.
Currently our treatment involves ANTI-INFLAMMATORIES and SURGERY.
ANTI-INFLAMMATORIES can be taken by mouth (like motrin, or tylenol), or they can be injected directly into the joint. Steroids are the medication that get injected into the knee to provide anti-inflammatory effects, which in turn improves pain. The problem: these injection only provide temporary relieve (anything from 1 week to 6 months).
But doctors and scientists are now finding promising ways to prolong the effect of steroids to last a longer time. A recent study published in the Journal of Bone & Joint Surgery (the leading orthopedic medical journal) suggests that one of these medications may work.
The drug FX006 (manufactured by Flexion: a publicly traded company) appears to provide significantly better pain relief at 8 weeks compared to the immediate-release version of the steroid (there are many types of steroid, the FX006 is a long acting version of Triamcinolone Acetonide, which is about 8x more potent that prednisone, which is your run-of-the-mill/standard steroid). Interestingly, small doses of the medication (10 mg) did not show any improvement compared to the standard injection, however at 40 mg, there was significant improvement. Doses stronger than that (60 mg) did not offer any additional pain relief.
Therefore it is suggested that a 40 mg injection of this long-acting medication may provide superior results compared to the standard injection. The question remains however, how reliably it prevents pain person-to-person because at this time, the efficacy of steroid injections is highly variable. Additionally, what is the added cost of this fancy new medication compared to the generic version which still works fairly well. One of the biggest concerns is that doctors have been down this road before with periarticular injections (see Exparel, Pacira) which initially held great promise, but over the past few years, studies have suggested that the "long-acting" effects of this medication does not lead to significant pain differences compared to standard generic periarticular injections (see study comparing the two).
At this time, the FX006 drug has not been FDA approved. Time will only tell if this medication provides true benefit compared to our generic steroid injections. If it does, it will address a significant issue that affects millions of Americans.