XG005 relieves knee osteoarthritis symptoms in phase 2b study

The experimental, non-opioid, oral agent XG005 inhibits inflammatory and neuropathic signals in patients with knee osteoarthritis (OA). In a phase 2b trial, XG005 demonstrated robust and consistent efficacy in alleviating OA symptoms and was well-tolerated, making this a promising treatment option for chronic OA.

XG005 is a non-opioid, dual-acting conjugate of an NSAID and a calcium channel inhibitor, simultaneously inhibiting inflammatory and neuropathic signals. The drug is in development in both oral and topical formulations. Dr Leon Jiang (Xgene Pharmaceutical Lexington, MA, USA) presented the results of a randomised-controlled, double-blind, phase 2b trial evaluating oral XG005 for Chinese patients with knee OA [1]. The 318 participants, recruited from 22 sites, had moderate-to-severe OA pain and Kellgren-Lawrence (KL) grade 2–3. Average Daily Walking Pain and Western Ontario and McMaster Universities Arthritis Index (WOMAC) pain at baseline were 5.87 and 4.59, respectively, on a numerical scale of 0–10; Knee Injury and Osteoarthritis Outcome Score (KOOS) was 52.46; and 43.2% had painDETECT scores ≥13, indicating neuropathic pain components. The participants were randomised 2:1:2 to XG005 750 mg twice daily, 500 mg twice daily, or placebo. The primary efficacy endpoint was change from baseline in weekly average Daily Walking Pain after 4 weeks.

At week 4, weekly average Daily Walking Pain in the XG005 750 mg group was significantly more reduced than in the placebo group: -2.3 versus -1.7 (P=0.0055). This difference was already significant after 1 week (P=0.0025). On the WOMAC Pain subscore, both doses of XG005 were significantly more effective compared with placebo: -2.2 (for both doses) versus +1.7 (750 mg: P=0.0054; 500 mg: P=0.0384). Both doses of XG005 were also superior to placebo in all other assessed secondary efficacy endpoints. XG005 was safe and well-tolerated, with no reported drug-related serious adverse events. The use of rescue medication was rare in both treatment and placebo arms.

1. Jiang L, et al. A phase 2b, randomized, double-blind, placebo-controlled, dose-ranging and parallel-group study to evaluate the safety and efficacy of XG005 in subjects with painful osteoarthritis of the knee. Abstract L08, ACR Convergence 2024, 14-19 November, Washington DC, USA.

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Posted on 13 January 202513 January 2025