Background: Osteoarthritis (OA) is characterized by increased cartilage thinning, bone remodeling, and inflammation. Post-traumatic OA, which develops after acute direct trauma to the joints, accounts for approximately 12% of all OA cases. 1 Current therapeutic options focus on alleviating symptoms and pain rather than disease modification. Lorecivivint (LOR; SM04690), an intra-articular (IA), small-molecule CLK2/DYRK1A inhibitor that modulates the Wnt pathway, has been shown in animal studies to induce chondrogenesis, protect cartilage, and reduce inflammation and, thereby, improve joint health. 2
Objectives: A single IA LOR injection was evaluated in a rat model of knee instability to determine its protective and regenerative effects when injected at different timepoints after induction of post-traumatic OA.
Methods: Knee instability/post-traumatic OA was surgically induced in rats by combining anterior cruciate ligament transection with partial medial meniscus transection (ACLT+pMMx). LOR (0.3 ug) or vehicle was injected into the IA space of the damaged knee at 2, 3, or 4 weeks after induction of OA. OA-induced (n=10/group) or sham-operated (surgery without ACLT+pMMx; n=5/group) rats were sacrificed at the injection timepoint (baseline) or 12 weeks following LOR/vehicle injection (study conclusion). Histological grades were evaluated using the summed OARSI scores (stage and grade of cartilage damage) 3 of the anterior and posterior medial femoral condyle (MFC) and medial tibial plateau (MTP). Weight distribution analysis was performed using an incapacitance meter at several timepoints. Statistical analysis was performed using one-way ANOVA with Dunnett’s multiple comparison test.
Results: ACLT+pMMx surgeries led to increased OARSI scores in rats compared with sham surgeries by 2 weeks. LOR treatment at Weeks 2, 3, and 4 led to significant decreases (
P
<0.05) in total joint OARSI scores (
OARSI scores
Week-2 injection |
Sham-operated
|
Baseline (BL
)
|
Vehicle
|
LOR
|
Total score | 5.99 | 19.17 | 31.36 | 19.19 |
SEM | 1.07 | 1.55 | 2.48 | 1.81 |
P value versus BL | 0.9999 | |||
P value versus vehicle | 0.0004 | |||
Week-3 injection |
Sham-operated
|
Baseline (BL
)
|
Vehicle
|
LOR
|
Total score | 6.09 | 23.17 | 30.45 | 21.20 |
SEM | 1.25 | 1.36 | 1.42 | 1.00 |
P value versus BL | 0.4522 | |||
P value versus vehicle | 0.0001 | |||
Week-4 injection |
Sham-operated
|
Baseline (BL
)
|
Vehicle
|
LOR
|
Total score | 6.97 | 16.88 | 24.95 | 18.63 |
SEM | 1.32 | 1.04 | 1.74 | 1.61 |
P value versus BL | 0.6257 | |||
P value versus vehicle | 0.0111 |
Conclusion: LOR exhibited cartilage-protective effects and slowed disease progression in the ACLT+pMMx model in vivo and, therefore, has potential as a structure-modifying treatment for OA.
REFERENCES:
[1]Brown TD, et al. J Orthop Trauma . 2006.
[2]Deshmukh V, et al. Osteoarthr Cartil. 2019.
[3]Pritzker KPH, et al. Osteoarthr Cartil . 2006.
Disclosure of Interests: Tim Seo Shareholder of: Samumed, LLC, Employee of: Samumed, LLC, Vishal Deshmukh Shareholder of: Samumed, LLC, Employee of: Samumed, LLC, Yusuf Yazici Shareholder of: Samumed, LLC, Employee of: Samumed, LLC