For people living with osteoarthritis, everyday activities such as walking, climbing stairs, or getting out of a chair can become increasingly difficult.
The disease affects hundreds of millions of people worldwide and is one of the leading causes of disability among older adults. Although doctors have many ways to manage pain, there is still no widely available medicine that can stop the disease from destroying cartilage.
That may eventually change thanks to new research from Yale University. Scientists have discovered that a medication originally developed to treat epilepsy could offer a completely different benefit: helping damaged joints heal while reducing pain at the same time.
The study, published in Bioactive Materials, focused on a medicine called lacosamide. Researchers found that when the drug was delivered directly into arthritic joints using a smart gel system, it reduced pain signals and helped protect cartilage from further damage.
To understand why this matters, it helps to know what happens in osteoarthritis. Many people think the disease is simply caused by years of wear and tear. While aging certainly plays a role, osteoarthritis is actually a complex biological process involving inflammation, abnormal cell activity, and the breakdown of tissues inside the joint.
Healthy joints contain cartilage, a smooth and flexible material that acts like a cushion between bones. Special cells called chondrocytes continuously maintain this tissue. They remove damaged cartilage and replace it with new material. In osteoarthritis, this repair system becomes unbalanced. Cartilage begins disappearing faster than it can be replaced.
The Yale researchers identified an important protein involved in this process called Nav1.7. Previous studies linked this protein mainly to pain signaling in nerves. However, the new research showed that Nav1.7 is also highly active inside cartilage cells affected by osteoarthritis.
When Nav1.7 becomes overactive, it appears to create a double problem. First, it increases pain signals. Second, it encourages cartilage cells to contribute to tissue breakdown instead of repair. This makes Nav1.7 a particularly attractive target because blocking it could potentially address two major problems at once.
The research team screened existing medications that affect sodium channels and found that lacosamide produced impressive results. Rather than simply reducing symptoms, the drug appeared to help restore balance inside cartilage cells.
Scientists observed that lacosamide encouraged the production of proteins associated with tissue protection and repair. Among these were HSP70 and midkine, molecules that help cells recover from damage and reduce harmful inflammation. These proteins created conditions that favored healthier cartilage maintenance.
The challenge then became finding the best way to deliver the medicine. Taking the drug by mouth exposes the entire body to treatment, which can increase the risk of side effects. Injecting medicine directly into the joint is more targeted, but most injected drugs are cleared away quickly.
To overcome this problem, the researchers developed a thermoresponsive hydrogel. This advanced material behaves like a liquid during injection but transforms into a soft gel once inside the body. The gel slowly releases the medication over time, allowing it to remain active inside the joint for weeks.
This delivery system produced encouraging results. In preclinical testing, a single injection every month provided stronger protection against cartilage loss than taking the medication orally every day. The hydrogel essentially turned the joint into its own treatment reservoir, maintaining drug levels where they were needed most.
An additional advantage is that lacosamide already has regulatory approval for epilepsy treatment. Because doctors already know a great deal about its safety profile, researchers may be able to move more quickly into human studies than they could with a completely new drug.
Analysis of the findings suggests this research is exciting because it targets the underlying disease process rather than simply controlling symptoms. The combination of a repurposed drug and innovative drug-delivery technology creates a practical pathway toward future treatments.
However, it is important to remember that the results are still at the preclinical stage. Human clinical trials will be necessary before doctors know whether the treatment works as effectively in patients as it does in laboratory studies.
If successful, this approach could offer a new generation of osteoarthritis treatments that preserve joints, reduce pain, and help patients maintain mobility for longer.
If you care about pain, please read studies about vitamin K deficiency linked to hip fractures in old people, and these vitamins could help reduce bone fracture risk.
For more health information, please see recent studies that Krill oil could improve muscle health in older people, and eating yogurt linked to lower frailty in older people.
The research was published in Bioactive Materials.
Source: Yale University.
