In a special Osteoarthritis and Cartilage issue, Dr. Guermazi and Dr. Roemer shape an Imaging atlas for eligibility and on-study safety of potential joint adverse events in anti-NGF studies. Recently, monoclonal antibodies that bind and inhibit nerve growth factor (a-NGF) have been introduced for treatment of OA symptoms and have shown good analgesic efficacy and improvement in function in patients with OA. However, despite initial promising data a-NGF trials in OA had been suspended due to concerns over accelerated rates of OA progression and other complications such as subchondral insufficiency fracture and osteonecrosis. Since a-NGF therapies offer potential as the first new class of analgesics for many years, future studies assessing a-NGF compounds will have to include stringent eligibility criteria and will require a rigorous safety monitoring. Imaging will play a crucial role in clinical trials to define eligibility of potential participants with focus on exclusion criteria and to monitor safety during the course of these studies to identify either subjects at risk for fast OA progression prior inclusion or withdraw subjects from study early to avoid adverse events such as rapid progressive OA.
The huge potential of aNGF drugs in the symptomatic treatment of osteoarthritis has been acknowledged by the research community and with imaging assessment being crucial in driving these studies, the Editor in Chief and the Editorial Board of Osteoarthritis and Cartilage, the leading journal in the field of osteoarthritis and the second journal in general orthopedics, have invited BICL’s Dr. Frank Roemer and Dr. Ali Guermazi as Guest Editors for this special OAC supplement acknowledging their leading expertise in this field. The atlases were specifically developed to illustrate in an exemplary fashion the imaging findings that may be encountered during a-NGF trials and/or in patients being treated with a-NGF compounds after possible approval of these drugs by the regulatory authorities.