Researchers have successfully combined a new hydrogel injection with systemic osteoporosis medications in rats, resulting in quick increases in local bone density. This research brings optimism for potential therapies aimed at preventing fractures in osteoporosis sufferers.
Osteoporosis is a condition where bone is lost faster than it’s produced, leading to weakened bone structure and an increased risk of fractures. Despite being widely acknowledged, Dominique Pioletti, who leads the Laboratory of Biomechanical Orthopedics at EPFL’s School of Engineering, points out that the economic and social effects of fractures caused by osteoporosis are often underrated.
“Without effective preventive strategies, about 40% of women over 50 will experience at least one serious osteoporotic fracture, while the figure is approximately 20% for men,” he notes. “Furthermore, many fail to fully grasp the seriousness of the illness. For older adults, fractures in the femoral neck, close to the hip, have a 20% chance of leading to death within a year, and more than half of those affected cannot resume their normal activities afterward.”
Upon a diagnosis of osteoporosis, patients typically undergo treatment with systemic drugs that either reduce the rate at which old bone is broken down (anti-catabolic) or enhance the formation of new bone (anabolic). However, these treatments can take nearly a year to show results, leaving patients at risk for fractures during that time.
Pioletti and his team at the EPFL start-up flowbone have created an injectable hydrogel designed to provide a quick, localized increase in bone density. Working with Vincent Stadelmann from the Schulthess Klinik in Zurich, they have recently shared exciting results of a therapy that merges these hydrogel injections with standard systemic medications. Their findings, which appeared in the journal Bone, indicate a four to five-fold increase in bone density in the legs of rats experiencing bone loss.
“This study is the first to verify that a combination therapy involving a systemically administered drug and a localized hydrogel injection can bring about swift increases in bone density, potentially transforming the approach to preventing fractures in osteoporosis,” says Pioletti.
Enhancing growth while inhibiting loss
Current osteoporosis treatments are mostly systemic, and the limited local treatments available typically come in the form of pastes that set like cement. In contrast, the injectable hydrogel developed at EPFL and flowbone consists of hyaluronic acid combined with hydroxyapatite nanoparticles, aiming to replicate the natural minerals found in bone.
The study revealed that hydrogel injections alone could boost local bone density by two to three times, regardless of systemic therapy. However, the most significant results were among rats treated with both a systemic anabolic medication (parathyroid hormone) and the hydrogel mixed with the anti-catabolic drug Zoledronate, leading to a remarkable up to 4.8-fold increase in bone density at the injection site within just 2 to 4 weeks.
“Our research indicates that injectable hydrogels providing localized anti-catabolic drug delivery can effectively enhance systemic anti-catabolic treatments or anabolic systemic treatments by rapidly augmenting local bone density,” Pioletti explains.
He further mentions that the flowbone team is currently seeking regulatory approval to proceed with clinical trials on human patients. “We aim to demonstrate the advantages of our hydrogel in scenarios requiring swift bone densification, such as supporting an implant in weak bone. Ultimately, we aspire to extend our findings into developing therapies to prevent fractures resulting from osteoporosis.”
