September. Copenhagen. 2-day Seminar on Arthrosamid (https://arthrosamid.com/).
Arthrosamid is the first new treatment mechanism I have seen in a long time.
It is an aqueous suspension of a polyacrylamide gel. It is a joint implant not a pharmaceutical. It has bene in use for years as a surgical tissue filler/implant in cosmetics, gynae and urology surgery and is known to be extremely safe.
When I first heard of it, I imagined it was a means of lining joint surfaces but in fact the mechanism is different altogether.
For practical purposes it is a “synovectomy’. In joints, the tissue that drives inflammation is the joint lining tissue or “synovium”. In health this is 1-2 cell layer thick lining and secretes healthy joint fluid. In disease it thickens, fills with immune and inflammatory cells, creates excess fluid (effusion) and drives inflammation which in turn drives pain. This is called synovitis and it is a feature of most joint diseases. If something is painful, in general it is inflamed.
In Osteoarthritis local damage drives the synovitis, in Rheumatoid and immune diseases it is driven by external immune reactions and antibodies etc.
Once injected in the knee, Arthrosamid has the remarkable property of incorporating into the synovium and then acting as a physical barrier to the between cell interactions which drive synovitis and slowly the inflammation simply subsides and with it swelling and pain. Historically, Yttrium (a radioactive isotope), Osmium (I’m not actually sure what Osmium is!) and surgery have been used for synovectomy so the concept isn’t new but the method is. The gel persists in the joint so the treatment effect does too and the clinical data is now out to 4 years (published) and 5 years (in preparation) with stable long-term benefits.
While licenced for the knee, local experience from Anders Hartkopp, a Copenhagen Rheumatologist who has used it for almost 10 years points to use in almost any joint with synovitis (shoulders are difficult).
Combined with rehab, 73% of patients respond to a single injection for up to 4-5 years as above. Within that, about 63% of older, heavier patients with end stage knees can expect about response, while 80% of younger, slimmer patients with earlier OA can expect benefit. Benefit is at least 50% improvement and again younger less arthritic patients can do better.
These are remarkable results, in my view.