New one-time shot for knee osteoarthritis comes with unknown risks

Newly hyped drug for OA is a risky high-tech version of an old remedy

It sure seems as if those with arthritis always get the dangerous end of the stick.

From addictive and deadly opioids to OTC pain meds that can destroy your liver, having arthritis these days is like trying to walk a tightrope… over a snake pit.

And if you’re one of the millions who suffer pain from knee osteoarthritis every day, don’t let your doctor rush you into shooting a just-out drug into your joint until you hear what it can really do to you.

The one-shot wonder
Zilretta is being hyped as the latest and greatest treatment for OA, a condition that’s sadly treated with opioids way too often. This new injection from drugmaker Flexion, however, doesn’t contain a dangerous, heavy-duty painkiller. Instead, it contains a synthetic steroid — and one that’s been in use for a long time.

Your doc may use both of those facts to try to sell you on Zilretta.

But here’s the thing: A lot of questions about this “groundbreaking new therapy” still remain unanswered.

For one, there’s the high-tech sounding “extended release microsphere technology” the company claims it utilizes so the drug will last longer — something that’s raised your cost from $20 to almost $600 a pop.

What it’s actually talking about are teeny microbeads containing the drug that are embedded with a chemical called PLGA — described as being “sort of a glue.”

But, unlike that cheaper treatment, get this — Zilretta is only approved by the FDA for a one-time injection. In fact, it says right on the drug’s label that the “safety of repeat administration of Zilretta” isn’t known.

Despite that warning, though, nothing is stopping your doctor from giving you multiple shots “off-label” once your pain returns. And with over 100 drug reps being sent out to meet, greet, and give the Zilretta sales pitch to more than 9,000 practitioners, you can bet rheumatologists all over the country will be stocked and ready.

In fact, docs are already saying that they’re anxious to shoot it into hips and shoulders, too — another off-label use.

But along with all the unknowns regarding those tiny, sticky beads, Zilretta also has a long list of possible side effects that can include “joint infection and damage,” even more pain and swelling, an increased risk of coming down with an infection, high blood pressure, and “gastrointestinal perforation,” especially if you have a peptic ulcer or diverticulosis.

And that’s just the short list.

Which is why it makes a lot of sense to opt for some tried and true drug-free methods for OA pain, which results from the gradual loss of cartilage in the joints.

Boswellia serrate is both anti-inflammatory and a potent pain reliever that you can find in supplement form.
Turmeric, another natural compound that can reduce joint pain and swelling, can be added to food to spice things up or taken as a supplement for a bigger dose.
Capsaicin, an effective topical way to relieve pain, is available both as a cream and an ointment.
Arnica, applied to your skin (or taken as a homeopathic remedy), is another safe way to ease sore joints. One brand, called T-Relief, is an ointment made with arnica and 12 other botanicals.
UC-II collagen is a supplement recommended by HSI panel member Dr. Mark Stengler as being more effective than that old standby for joints, glucosamine and chondroitin.
Epsom salt baths are an age-old method of reducing joint pain. Adding two cups of Epsom salt to a warm bath — something that, unlike Zilretta, you can do as often as necessary — makes for a soothing soak!
Vitamin D can be a big help in reducing inflammation. In fact, there’s a strong link between low D levels and OA.

And if the sun is still shining in your neck of the woods, head out for a walk right now. Not only will you get a “dose” of vitamin D (in the best form possible!), but Boston University researchers recently found that walking is the best treatment for knee OA.

“Hot to trot with Zilretta, Flexion rolls $100M-plus stock offering to fund the launch” Tracy Staton, October 11, 2017, FiercePharma, fiercepharma.com