Compositions and methods for treating articular cartilage disorders

Abstract

A method for treating mammalian articular cartilage disorders, more particularly osteoarthritis, and trauma-related cartilage injuries using insulin-like growth factor I (IGF-I) is provided. The method comprises increasing the amount of IGF-I at the diseased or injured articular site to a therapeutically effective level that is capable of maintenance and/or regeneration of cartilage, which is beneficial to the long-term treatment of osteoarthritis and trauma-related injuries to cartilage tissues. In one embodiment of the invention, single doses of at least 0.01 mg of pharmaceutically effective IGF-I are administered intermittently such that the duration of time off of therapy is greater than the time on therapy, more preferably with a frequency of administration of about once per week or less.

1 . A method for treating an articular cartilage disorder at an articular site in a mammal, said method comprising increasing IGF-I at said articular site to a therapeutically effective level that is capable of promoting a desired positive effect on cartilage of said articular site, said articular site being selected from the group consisting of a hand joint, a foot joint, a knee joint, a shoulderjoint, a hip joint, and ajoint within the spine, wherein said increasing is achieved by delivering to said articular site a therapeutically effective dose of human IGF-I or biologically active variant thereof, wherein said dose is about 0.01 mg to about 50.0 mg, wherein said variant is a polypeptide having IGF-I activity and having at least 70% sequence identity to the amino acid sequence of said human IGF-I, and wherein said IGF-I activity is stimulation of proteoglycan synthesis.  
   
   
       2 . The method of  claim 1 , wherein said therapeutically effective dose of human IGF-I or variant thereof is about 0.1 mg to about 20.0 mg.  
   
   
       3 . The method of  claim 1 , wherein said method comprises administering said therapeutically effective dose directly to said articular site.  
   
   
       4 . The method of  claim 3 , wherein said administering is by intra-articular injection.  
   
   
       5 . The method of  claim 4 , wherein said articular cartilage disorder is osteoarthritis.  
   
   
       6 . The method of  claim 5 , wherein said osteoarthritis is localized idiopathic osteoarthritis.  
   
   
       7 . The method of  claim 5 , wherein said osteoarthritis is secondary osteoarthritis.  
   
   
       8 . The method of  claim 4 , wherein said articular cartilage disorder results from a trauma-related injury.  
   
   
       9 . The method of  claim 4 , wherein said mammal is a human and wherein human IGF-I is administered.  
   
   
       10 . The method of  claim 3 , wherein said therapeutically effective dose of human IGF-I or variant thereof is administered intermittently.  
   
   
       11 . The method of  claim 10 , wherein said intermittent administration comprises an administration of a pharmaceutical composition comprising said therapeutically effective dose of human IGF-I or variant thereof followed by a time period of discontinuance, wherein said period of discontinuance is longer than the residence time of said pharmaceutical composition at said site, and repetition of the pattern of administration followed by discontinuance for as long as necessary to achieve said treatment of said articular cartilage disorder.  
   
   
       12 . The method of  claim 11 , wherein said therapeutically effective dose of human IGF-I or variant thereof is selected from the group consisting of 0.3 mg, 1.0 mg, and 3.0 mg.  
   
   
       13 . The method of  claim 12 , wherein said human IGF-I or variant thereof is administered as a sustained-release formulation.  
   
   
       14 . A method for treating degenerative disk disease at an articular site within a spine of a mammal, said method comprising increasing IGF-I at said articular site to a therapeutically effective level that is capable of promoting a desired positive effect on cartilage of said articular site, wherein said increasing is achieved by delivering to said articular site a therapeutically effective dose of human IGF-I or biologically active variant thereof, wherein said dose is about 0.01 mg to about 50.0 mg, wherein said variant is a polypeptide having IGF-I activity and having at least 70% sequence identity to the amino acid sequence of said human IGF-I, and wherein said IGF-I activity is stimulation of proteoglycan synthesis.  
   
   
       15 . The method of  claim 14 , wherein said method comprises administering said therapeutically effective dose directly to said articular site.  
   
   
       16 . The method of  claim 15 , wherein said administering is by intra-articular injection.  
   
   
       17 . The method of  claim 16 , wherein said mammal is a human and wherein human IGF-I is administered.  
   
   
       18 . The method of  claim 15 , wherein said therapeutically effective dose of human IGF-I or variant thereof is administered intermittently.  
   
   
       19 . The method of  claim 18 , wherein said intermittent administration comprises an administration of a pharmaceutical composition comprising said therapeutically effective dose of human IGF-I or variant thereof followed by a time period of discontinuance, wherein said period of discontinuance is longer than the residence time of said pharmaceutical composition at said site, and repetition of the pattern of administration followed by discontinuance for as long as necessary to achieve said treatment of said articular cartilage disorder.  
   
   
       20 . The method of  claim 19 , wherein said therapeutically effective dose of human IGF-I or variant thereof is selected from the group consisting of 0.3 mg, 1.0 mg, and3.0 mg.