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Lynen NA, Eichhorn C, Portelange N, Chausson M, Weyenberg W. Long-Term Efficacy Following Intra-articular Injection of Carboxymethyl-chitosan, a New Product Class for Knee Osteoarthritis: Results from an Observational Study in Germany. Rheumatol Ther 2024; 11:649-662. [PMID: 38498142 PMCID: PMC11111638 DOI: 10.1007/s40744-024-00661-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 02/29/2024] [Indexed: 03/20/2024] Open
Abstract
INTRODUCTION Evaluate the real-world efficacy of a single intra-articular injection of carboxymethyl-chitosan (CM-chitosan), a new product class for knee osteoarthritis (OA). METHODS This post-marketing study included adult patients with knee OA, who received a single injection of 60 mg CM-chitosan (currently marketed as KioMedinevsone) according to the instructions for use. Follow-up was performed at weeks 1, 12, 24, and 36. Efficacy was evaluated using a Visual Analog Scale (VAS) score for pain, the Knee injury and Osteoarthritis Outcome Score (KOOS), Patient's Global Assessment (PGA), and overall patient satisfaction. RESULTS Forty-nine patients were included in the study. VAS pain score significantly decreased from a median of 49.0 mm at baseline to 24.0 mm at week 1 and to 18 mm at week 36. Pain improvement was stable since at week 36; 91.8% of patients confirmed pain reduction. All KOOS subscales (symptoms, pain, activities of daily living, sports and recreational activities, quality of life) improved significantly compared to baseline at all time points. KOOS pain improved progressively from a median of 58.3% at baseline (mean 56.2 ± 18.8%) to 86.1% (mean 74.1 ± 24%) at week 36 compared to baseline. Overall, more than 70% of patients reported a condition gain (PGA), matching well with the more than 75% of patients being satisfied with the treatment. At 6 months, 72.7% of the patients could be classified as responder according to the OMERACT-OARSI proposed set of responder criteria. CONCLUSION CM-chitosan showed a rapid onset of pain relief after 1 week and with a duration of 9 months. In a real-world setting, treatment with CM-chitosan would appear to be a potentially effective option to reduce pain and improve physical function and global condition in patients with knee OA, opening new perspectives in patients who are considered as refractory to current symptomatic therapies and where the unmet need is high. TRIAL REGISTRATION NUMBER NCT04757051 (ClinicalTrials.gov).
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Affiliation(s)
| | | | | | | | - Wim Weyenberg
- KiOmed Pharma, 4 rue Haute Claire, 4040, Herstal, Belgium
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Deng J, Wei R, Qiu H, Wu X, Yang Y, Huang Z, Miao J, Liu A, Chai H, Cen X, Wang R. Biomimetic zwitterionic copolymerized chitosan as an articular lubricant. Carbohydr Polym 2024; 330:121821. [PMID: 38368102 DOI: 10.1016/j.carbpol.2024.121821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 12/22/2023] [Accepted: 01/11/2024] [Indexed: 02/19/2024]
Abstract
Restoration of the lubrication functions of articular cartilage is an effective treatment to alleviate the progression of osteoarthritis (OA). Herein, we fabricated chitosan-block-poly(sulfobetaine methacrylate) (CS-b-pSBMA) copolymer via a free radical polymerization of sulfobetaine methacrylate onto activated chitosan segment, structurally mimicking the lubricating biomolecules on cartilage. The successful copolymerization of CS-b-pSBMA was verified by Fourier transform infrared spectroscopy, X-ray photoelectron spectroscopy, and 1H nuclear magnetic resonance. Friction test confirmed that the CS-b-pSBMA copolymer could achieve an excellent lubrication effect on artificial joint materials such as Ti6Al4V alloy with a coefficient of friction as low as 0.008, and on OA-simulated cartilage, better than the conventional lubricant hyaluronic acid, and the adsorption effect of lubricant on cartilage surface was proved by a fluorescence labeling experiment. In addition, CS-b-pSBMA lubricant possessed an outstanding stability, which can withstand enzymatic degradation and even a long-term storage up to 4 weeks. In vitro studies showed that CS-b-pSBMA lubricant had a favorable antibacterial activity and good biocompatibility. In vivo studies confirmed that the CS-b-pSBMA lubricant was stable and could alleviate the degradation process of cartilage in OA mice. This biomimetic lubricant is a promising articular joint lubricant for the treatment of OA and cartilage restoration.
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Affiliation(s)
- Junjie Deng
- Cixi Biomedical Research Institute, Wenzhou Medical University, Zhejiang 315300, PR China; Zhejiang International Scientific and Technological Cooperative Base of Biomedical Materials and Technology, Institute of Biomedical Engineering, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo 315201, PR China; Ningbo Cixi Institute of Biomedical Engineering, Ningbo 315300, PR China
| | - Rufang Wei
- Cixi Biomedical Research Institute, Wenzhou Medical University, Zhejiang 315300, PR China; Zhejiang International Scientific and Technological Cooperative Base of Biomedical Materials and Technology, Institute of Biomedical Engineering, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo 315201, PR China; Ningbo Cixi Institute of Biomedical Engineering, Ningbo 315300, PR China
| | - Haofeng Qiu
- Zhejiang International Scientific and Technological Cooperative Base of Biomedical Materials and Technology, Institute of Biomedical Engineering, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo 315201, PR China; Ningbo Cixi Institute of Biomedical Engineering, Ningbo 315300, PR China; School of Materials Science and Engineering, Nanjing University of Science & Technology, Nanjing 210094, PR China
| | - Xiang Wu
- Ningbo Medical Center Li Huili Hospital; Health Science Center, Ningbo University, Ningbo 315000, PR China
| | - Yanyu Yang
- Cixi Biomedical Research Institute, Wenzhou Medical University, Zhejiang 315300, PR China; Zhejiang International Scientific and Technological Cooperative Base of Biomedical Materials and Technology, Institute of Biomedical Engineering, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo 315201, PR China; Ningbo Cixi Institute of Biomedical Engineering, Ningbo 315300, PR China
| | - Zhimao Huang
- Zhejiang International Scientific and Technological Cooperative Base of Biomedical Materials and Technology, Institute of Biomedical Engineering, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo 315201, PR China; Ningbo Cixi Institute of Biomedical Engineering, Ningbo 315300, PR China
| | - Jiru Miao
- Zhejiang International Scientific and Technological Cooperative Base of Biomedical Materials and Technology, Institute of Biomedical Engineering, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo 315201, PR China; Ningbo Cixi Institute of Biomedical Engineering, Ningbo 315300, PR China
| | - Ashuang Liu
- Cixi Biomedical Research Institute, Wenzhou Medical University, Zhejiang 315300, PR China; Zhejiang International Scientific and Technological Cooperative Base of Biomedical Materials and Technology, Institute of Biomedical Engineering, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo 315201, PR China; Ningbo Cixi Institute of Biomedical Engineering, Ningbo 315300, PR China
| | - Haiyang Chai
- Cixi Biomedical Research Institute, Wenzhou Medical University, Zhejiang 315300, PR China; Zhejiang International Scientific and Technological Cooperative Base of Biomedical Materials and Technology, Institute of Biomedical Engineering, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo 315201, PR China; Ningbo Cixi Institute of Biomedical Engineering, Ningbo 315300, PR China
| | - Xiao Cen
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, 610041, Sichuan, PR China; Department of Temporomandibular Joint, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd Section, South Renmin Road, Chengdu, 610041, Sichuan, PR China.
| | - Rong Wang
- Cixi Biomedical Research Institute, Wenzhou Medical University, Zhejiang 315300, PR China; Zhejiang International Scientific and Technological Cooperative Base of Biomedical Materials and Technology, Institute of Biomedical Engineering, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo 315201, PR China; Ningbo Cixi Institute of Biomedical Engineering, Ningbo 315300, PR China.
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Kong Y, Ma S, Zhou F. Bioinspired Interfacial Friction Control: From Chemistry to Structures to Mechanics. Biomimetics (Basel) 2024; 9:200. [PMID: 38667211 PMCID: PMC11048105 DOI: 10.3390/biomimetics9040200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 03/22/2024] [Accepted: 03/22/2024] [Indexed: 04/28/2024] Open
Abstract
Organisms in nature have evolved a variety of surfaces with different tribological properties to adapt to the environment. By studying, understanding, and summarizing the friction and lubrication regulation phenomena of typical surfaces in nature, researchers have proposed various biomimetic friction regulation theories and methods to guide the development of new lubrication materials and lubrication systems. The design strategies for biomimetic friction/lubrication materials and systems mainly include the chemistry, surface structure, and mechanics. With the deepening understanding of the mechanism of biomimetic lubrication and the increasing application requirements, the design strategy of multi-strategy coupling has gradually become the center of attention for researchers. This paper focuses on the interfacial chemistry, surface structure, and surface mechanics of a single regulatory strategy and multi-strategy coupling approach. Based on the common biological friction regulation mechanism in nature, this paper reviews the research progress on biomimetic friction/lubrication materials in recent years, discusses and analyzes the single and coupled design strategies as well as their advantages and disadvantages, and describes the design concepts, working mechanisms, application prospects, and current problems of such materials. Finally, the development direction of biomimetic friction lubrication materials is prospected.
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Affiliation(s)
- Yunsong Kong
- State Key Laboratory of Solid Lubrication, Lanzhou Institute of Chemical Physics, Chinese Academy of Sciences, Lanzhou 730000, China; (Y.K.); (F.Z.)
- College of Materials Science and Opto-Electronic Technology, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Shuanhong Ma
- State Key Laboratory of Solid Lubrication, Lanzhou Institute of Chemical Physics, Chinese Academy of Sciences, Lanzhou 730000, China; (Y.K.); (F.Z.)
| | - Feng Zhou
- State Key Laboratory of Solid Lubrication, Lanzhou Institute of Chemical Physics, Chinese Academy of Sciences, Lanzhou 730000, China; (Y.K.); (F.Z.)
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Manivong S, Cullier A, Audigié F, Banquy X, Moldovan F, Demoor M, Roullin VG. New trends for osteoarthritis: Biomaterials, models and modeling. Drug Discov Today 2023; 28:103488. [PMID: 36623796 DOI: 10.1016/j.drudis.2023.103488] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 12/26/2022] [Accepted: 01/03/2023] [Indexed: 01/08/2023]
Abstract
The burden of osteoarthritis (OA), one of the major causes of functional disabilities in humans and animals, continues to increase worldwide while no disease-modifying OA drugs (DMOADs) that either slow down or reverse disease progression have been made available. Here, we provide a brief overview of recent advances in: designing new OA drug delivery approaches, focusing on lubrication-based biomaterials and drug delivery systems, such as hydrogels, liposomes, dendrimers, micro- and nanoparticles; using either large (horse) or small (zebrafish) relevant animal models to evaluate new therapeutic strategies; and OA in vitro modeling, focusing on 3D (organoid) models of cartilage regarding the Replace, Reduce and Refine (3R) principle of animal experimentation.
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Affiliation(s)
- Seng Manivong
- Faculty of Pharmacy, Faculty of Dentistry, and CHU Sainte-Justine Research Centre, Université de Montréal, Montréal, QC, Canada
| | | | - Fabrice Audigié
- Center of Imaging and Research in Locomotor Affections on Equines, Veterinary School of Alfort, Goustranville, France
| | - Xavier Banquy
- Faculty of Pharmacy, Faculty of Dentistry, and CHU Sainte-Justine Research Centre, Université de Montréal, Montréal, QC, Canada
| | - Florina Moldovan
- Faculty of Pharmacy, Faculty of Dentistry, and CHU Sainte-Justine Research Centre, Université de Montréal, Montréal, QC, Canada
| | - Magali Demoor
- Normandie University, UNICAEN, BIOTARGEN, Caen, France.
| | - V Gaëlle Roullin
- Faculty of Pharmacy, Faculty of Dentistry, and CHU Sainte-Justine Research Centre, Université de Montréal, Montréal, QC, Canada.
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Emans P, Skaliczki G, Haverkamp D, Bentin J, Chausson M, Schifflers M, Hermitte L, Douette P. First-in-human Study to Evaluate a Single Injection of KiOmedine®CM-Chitosan for Treating Symptomatic Knee Osteoarthritis. Open Rheumatol J 2022. [DOI: 10.2174/18743129-v16-e2206100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
Single-injection viscosupplementation is currently performed with cross-linked hyaluronan (e.g., Durolane®) for treating symptomatic knee osteoarthritis.
Objective:
This first-in-human study evaluated the safety and performance of single-injection treatment with non-crosslinked KiOmedine®CM-Chitosan.
Methods:
Patients with painful knee osteoarthritis were randomly assigned to the KiOmedine®CM-Chitosan (n=63) or Durolane® (n=32) group. Patients were blinded to treatment and followed up for 26 weeks. Durolane® was used as scientific control to ensure the validity of the study and reliability of results. No direct comparison was performed between the two groups. The primary objective was defined as an intra-group effect size of 0.8 at 13 weeks post-injection compared to baseline on WOMAC-A (pain). Secondary outcomes included self-reported knee stiffness and knee function, responder rate, quality-of-life questionnaires, and safety.
Results:
The primary objective for both the KiOmedine®CM-Chitosan and the Durolane® groups was met: mean pain reduction of 62.5% (effect size 2.08) for the KiOmedine®CM-Chitosan group and 62.4% (effect size 2.28) for the Durolane® group. Secondary performance outcomes showed all clinically relevant treatment effects over 26 weeks for both groups (p<0.05). Treatment-related adverse events were more often reported in the KiOmedine®CM-Chitosan than Durolane® group and were limited to local reactions. No serious treatment-related adverse events were reported.
Conclusion:
A single intra-articular injection of non-crosslinked KiOmedine®CM-Chitosan is safe and effective for treating symptomatic knee osteoarthritis with a high responder rate. Pain reduction is maintained for 6 months with a high responder rate.
The clinical trial registration number: NCT03679208.
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