Osteoarthritis is the most common form of arthritis. It usually occurs in people aged over 50 and results in cartilage degeneration, chronic knee pain, and disability. Wearing away of the cartilage results in bone wearing upon bone and causes great pain.
Stem cell treatment for osteoarthritis (OA) of the knee has been rising in popularity and a quick search of the clinical trials database shows that there are nearly 100 active or completed clinical trials using stem cells to treat OA of the knee.
The types of stem cells being used vary, and where the stem cells are being sourced from also varies.
Mesenchymal stem cells, or MSCs, have emerged as a cell type with great potential for cell-based cartilage repair in patients with knee OA.
The reason that MSCs are emerging as the most suitable cell type is because of their ability to modulate the immune system and to potentially break the destructive cycle of inflammation, joint degradation, pain and reduced mobility.
In many trials these cells are derived from adipose (fat) tissue, umbilical cord and bone marrow. The trials also use both autologous and allogenic treatments.
Autologous being stem cells from the patient receiving the treatment and allogenic being stem cells from another donor.
Recently a study at the Krembil Research Institute, University Health Network, Toronto using autologous treatment of MSCs derived from bone marrow showed significant improvements in the OA patients’ pain levels and quality of life.
It also showed that the MSCs were safe at all the doses and that the higher the dose, the more effective the outcome.
Largest MSC study to begin this year
Cynata Therapeutics (ASX:CYP) will be kicking off a 448-person phase two clinical trial later this year with the University of Sydney using its MSCs.
The unique thing about Cynata’s MSCs is that they are not derived from bone marrow, umbilical cord or adipose tissue, but manufactured using its proprietary platform, dubbed Cymerus™.
The Cymerus platform is able to do this because of its use of induced pluripotent stem cells, or iPSCs for short, as the starting material for manufacture of the finished MSC product.
iPSCs are stem cells reprogrammed into an embryonic state which gives them the ability to be grown into any cell type and infinitely expand (i.e. reproduce themselves) – and in this case they are manufactured into MSCs.
The platform only required one blood donation, one time, from one donor. This means it can create an essentially infinite amount of consistent, highly potent, pharmaceutical grade stem cells – making its stem cells particularly well suited to large clinical trials and to commercial applications, such as a treatment for osteoarthritis.
While autologous treatments do not require a clinical approval pathway, they can never be a truly off-the-shelf treatment, whereas an allogenic treatment is scalable.
Looking at the list of clinical trials in OA using stem cells, there are far fewer using allogenic stem cells.
Cynata’s upcoming clinical trial in OA is therefore set to be one of the world’s largest trials using MSCs.
A multibillion-dollar market
In the US, OA is the most prevalent joint disease and a leading source of chronic pain and disability and knee OA accounts for more than 80 percent of the disease’s total burden.
According to Zion research, the global osteoarthritis drug market was valued at approximately US$5.9 billion in 2018 and is expected to generate around US$10.3 billion by 2025.
Knee replacement is currently the leading treatment for patients. It is estimated that US$3.6 billion was spent on knee replacements in 2016.
Stem cell treatment could provide a far less invasive alternative with much shorter recovery periods – making it a very viable and attractive alternative.
This content is produced by Star Investing in commercial partnership with Cynata Therapeutics. This content does not constitute financial product advice. You should consider obtaining independent advice before making any financial decisions.
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