A team from Yale University has discovered that the epilepsy drug lacosamide can help to alleviate the pain and reverse the cartilage damage associated with osteoarthritis.

Although current treatments for osteoarthritis include over-the-counter medications or steroid injections, these solutions only dull the pain temporarily and do not stop the joint from deteriorating.

Source: Yale University

The team suggests that the lacosamide functions as a dual-purpose treatment that simultaneously alleviated joint pain and reversed cartilage damage in osteoarthritis — particularly when a specialized hydrogel is used to deliver the drug directly into the joint.

In healthy joints, chondrocytes maintain cartilage by balancing both tissue formation and breakdown. In the case of osteoarthritis, this balance shifts toward cartilage destruction, thus expediting joint damage until bones rub together, which typically leads to the need for joint replacement surgery.

While there is no current FDA-approved medicine capable of both halting joint pain and preventing the structural cartilage from breaking down, repurposing an existing medication and delivering it through a high-tech smart gel will protect joints and offer long-lasting relief.

The team discovered that the sodium channel Nav1.7, which has been previously linked mainly to pain-sensing nerves, is also present in cartilage-maintaining chondrocytes during osteoarthritis. When overactive, Nav1.7 not only increases pain but also triggers cartilage breakdown. This makes it a promising target for treating both symptoms and joint damage.

In the lab, the team repurposed the lacosamide, which blocked Nav1.7 and simultaneously promoted cartilage repair while also reducing tissue degradation. Further, the medication also stimulated the protective proteins HSP70 and midkine, both of which support tissue repair and control inflammation.

The team then sought to improve delivery by developing a thermoresponsive collagen-based hydrogel that solidifies within the joint and slowly releases lacosamide over the course of many weeks. During trials, a single injection every four weeks outperformed daily oral treatment in terms of preventing cartilage loss.

An article detailing the findings, “Collagen II hydrogel-mediated sustained delivery of lacosamide attenuates cartilage degeneration and pain in osteoarthritis,” appears in the journal Bioactive Materials.