Certain Dosages of Fasinumab Provides Superior Benefits over Placebo in Mitigating Osteoarthritis Symptoms Albeit at Increased Health Detriments: A Systematic Review and Meta-Analysis

Muhammad Sohaib Khan¹, Wania Moeen², Umm E Salma Shabbar Banatwala², Muhammad Usman², Umar Mahmood², Syed Ashad Ahmed Fatmi², Syed Muhammad Muneeb Akhtar², Hania Shahzad³, Muhammad Talal Ibrahim⁴, Nisar Ahmed⁵, Badaruddin Sahito² and Muhammad Sohaib Asghar⁶, ¹Dow University of Health Sciences, Karachi, Pakistan, ²Dow University of Health Sciences, Karachi, Sindh, Pakistan, ³UC Davis Health, Sacramento, CA, ⁴The Ohio State University Wexner Medical Center, Columbus, OH, ⁵Rapido’s Clinica Familiar, Chicago, ⁶AdventHealth, Sebring, FL

Meeting: ACR Convergence 2024

Keywords: meta-analysis, Osteoarthritis, Pharmacoepidemiology

Session Information

Date: Sunday, November 17, 2024

Title: Osteoarthritis – Clinical Poster I

Session Type: Poster Session B

Session Time: 10:30AM-12:30PM

Background/Purpose: Fasinumab, a newly developed anti-nerve growth factor monoclonal antibody, is currently under investigation for its potential to alleviate symptoms in osteoarthritis patients. This meta-analysis aims to analyze the efficacy and safety of Fasinumab compared to placebo in osteoarthritis patients.

Methods: PubMed (MEDLINE), Cochrane CENTRAL, ClinicalTrials.gov, and Google Scholar were searched for double-blinded Randomized Control Trials (RCTs) comparing Fasinumab with placebo till February 2024. Primary outcomes were WOMAC pain, WOMAC function, and Patient Global Assessment (PGA) scores. Cochrane Risk of Bias 2 was used for quality assessment. Statistical analysis was carried out using a Random Effects model. Subgroups based on dosages were also made.

Results: Six RCTs involving 9,429 participants were included. At 16 weeks, 1 mg Subcutaneous (SC) Every four weeks (Q4W), 1 mg SC Every eight weeks (Q8W), and 3 mg SC Q4W showed a greater statistically significant reduction in WOMAC pain and function scores compared to placebo. However, according to minimal clinically important differences (MCIDs), only 1mg SC Q4W and 3mg SC Q4W may provide clinically meaningful reductions in WOMAC pain ([MD: -1.05, (95% C.I. -1.32 to -0.78), p< 0.00001, I²=28%] and [MD: -1.16, (95% C.I. -1.58 to -0.75), p< 0.00001, I²=0%], respectively) and function scores ([-1.05 (95% C.I. -1.32 to -0.79), p< 0.00001, I²=20%] and [MD: -1.24, (95% C.I. -1.65 to -0.83), p< 0.00001, I²=0%], respectively) more than placebo. A 1 mg SC Q4W dosage regimen is also favored over a placebo in improving PGA scores at 16 weeks. However, Fasinumab use increases the risk of adverse events, including Joint-replacement surgery and Adjudicated Arthropathy.

Conclusion: Specific Fasinumab dosages showed greater efficacy in alleviating pain and improving function and PGA scores compared to placebo. However, Fasinumab use may be associated with increased health detriments, such as increased risk of adjudicated arthropathy and all-cause joint replacement.

Figure 1. Forest plot of comparison: Fasinumab vs Placebo, outcome: Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) Pain at 16 weeks. SC, Subcutaneous; Q4W, Every Four Weeks; Q8W, Every Eight Weeks; mg, milligrams.

Figure 2. Forest plot of comparison: Fasinumab vs Placebo, outcome: Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) Function at 16 weeks. SC, Subcutaneous; Q4W, Every Four Weeks; Q8W, Every Eight Weeks; mg, milligrams.

Figure 3. Forest plot of comparison: Fasinumab vs Placebo, outcome: Patient Global Assessment (PGA) at 16 weeks. SC, Subcutaneous; Q4W, Every Four Weeks; Q8W, Every Eight Weeks; mg, milligrams.

Disclosures: M. Khan: None; W. Moeen: None; U. Shabbar Banatwala: None; M. Usman: None; U. Mahmood: None; S. Ahmed Fatmi: None; S. Muneeb Akhtar: None; H. Shahzad: None; M. Ibrahim: None; N. Ahmed: None; B. Sahito: None; M. Asghar: None.

To cite this abstract in AMA style:

Khan M, Moeen W, Shabbar Banatwala U, Usman M, Mahmood U, Ahmed Fatmi S, Muneeb Akhtar S, Shahzad H, Ibrahim M, Ahmed N, Sahito B, Asghar M. Certain Dosages of Fasinumab Provides Superior Benefits over Placebo in Mitigating Osteoarthritis Symptoms Albeit at Increased Health Detriments: A Systematic Review and Meta-Analysis [abstract]. Arthritis Rheumatol. 2024; 76 (suppl 9). https://acrabstracts.org/abstract/certain-dosages-of-fasinumab-provides-superior-benefits-over-placebo-in-mitigating-osteoarthritis-symptoms-albeit-at-increased-health-detriments-a-systematic-review-and-meta-analysis/. Accessed .

ACR Meeting Abstracts - https://acrabstracts.org/abstract/certain-dosages-of-fasinumab-provides-superior-benefits-over-placebo-in-mitigating-osteoarthritis-symptoms-albeit-at-increased-health-detriments-a-systematic-review-and-meta-analysis/