Researchers at Yale University have identified a potential new approach to osteoarthritis that goes beyond symptom relief. In a study published in Bioactive Materials, they showed that lacosamide, a drug already approved for epilepsy, can reduce joint pain and also help reverse cartilage damage in preclinical models. The work targets a protein called Nav1.7, a sodium channel that becomes overactive in osteoarthritic joints and contributes both to pain signaling and to the breakdown of cartilage by chondrocytes.
Rather than developing a new molecule, the team tested existing sodium-channel inhibitors and found lacosamide to be particularly potent at low concentrations. The drug worked best within a narrow dose range, stimulating production of cartilage-building proteins while suppressing degradative processes. It also boosted two beneficial signaling proteins, HSP70 and midkine, which help create a tissue-repair environment.
To avoid side effects from systemic exposure, the researchers used intra-articular injection with a specialized hydrogel that keeps the drug inside the joint. This approach allowed sustained local delivery and enhanced the drug's protective effects. The study's lead investigator, Chuan-Ju Liu, emphasized that the goal is a therapy that changes disease progression, not just masks pain.
This is a single preclinical study, and the results, while promising, have not yet been tested in human trials. The findings do suggest that repurposing an existing drug and delivering it locally could offer a dual benefit for the millions affected by osteoarthritis, but further research is needed to confirm safety and efficacy in people.