pSivida (ASX:PVA), a leader in the development of sustained release drug delivery products for eye diseases, and Hospital for Special Surgery (HSS), America's leading specialty hospital devoted to orthopaedics and rheumatology, have announced the opening of an investigational new drug application (IND) to begin an investigator-sponsored clinical study of a sustained-release implant to treat severe osteoarthritis (OA) of the knee.
The implant is designed to provide long-term pain relief for severe knee OA, which the company said could delay the need for knee replacement surgery.
"The implant is surgically implanted into the non-articulating area of the knee in an outpatient procedure," said the company in a statement. "While the study is designed to evaluate the implant for six months, the duration of release following a single treatment is expected to extend to one year or more."
Dr Mark Figgie, Chief of the Surgical Arthritis Service at HSS, filed the IND and will serve as the principal investigator for the investigator-sponsored study. Dr Figgie is a leading expert in joint replacement for inflammatory arthritis and performs more than 500 joint replacement surgeries each year. With training in engineering and biomechanics, he has been instrumental in the design of implants for elbows, knees and hips.
Knee OA is a degenerative joint disease that results from breakdown of joint cartilage and underlying bone, with joint pain and stiffness as the most common symptoms. Nearly 50 per cent of all people over 85 develop symptomatic knee OA, and two-thirds of obese people develop it in their lifetimes. No cure exists, but pain and movement restriction associated with the disease are currently treated with oral analgesics, non-steroidal anti-inflammatory drugs, corticosteroids taken orally or injected into the knee or hyaluronic acid injected into the knee.
With degeneration, damage and pain from knee OA can become severe, making it the leading cause of total knee replacement surgery. More than 700,000 of these surgeries were performed last year in the US alone, and the number is expected to grow. Recent data from the Centers for Disease Control indicate that total knee replacements doubled between 2000 and 2010 for Americans over age 45, due in part to longer life expectancies and increases in obesity.
"We believe this product has the potential to provide long-term pain relief and to contribute to improved joint function for patients with severe osteoarthritis, which can delay knee replacement surgery. Implanting a small, secure reservoir that delivers a corticosteroid on a sustained basis directly to the knee could avoid the issues with systemic steroid delivery and repetitive knee injections. This implant, the result of the combined insights HSS and the expertise of pSivida, has the potential to create a paradigm shift in a variety of conditions," said Dr Robert Hotchkiss, Medical Director of Clinical Research, HSS.
Dr Paul Ashton, President and CEO of pSivida, said, "This IND is an important step in pSivida's goal of becoming the leader in sustained-release drug delivery products in ophthalmology and beyond. We hope to use our technologies to treat many chronic or debilitating conditions that require sustained, localized delivery of a drug."
The study is an open-label, single dose, safety and tolerability study of the screw implant to deliver dexamethasone, a corticosteroid previously proven to provide pain relief in knee osteoarthritis.