An Arthritis Treatment Worthy of the Pope and Kobe

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Regenokine isn't approved by the FDA (yet), but the treatment for joint pain is promising.

knee xray 615.jpgmtkopone/Flickr

The likes of Kobe Bryant, Alex Rodriguez, Vijay Singh, and Pope John Paul II are among a growing number -- myself included -- who have sought a novel form of anti-inflammatory arthritis/tendinitis treatment that, until recently, was only available in Germany. If you haven't already heard about it, it's called Regenokine, and it's among a trend moving orthopedics away from operating rooms and into the realm of the molecular -- from mining titanium to mining the anti-inflammatory molecules coursing through our veins. 

The premise is that the critical problem in arthritis is inflammation, not the mechanical consequences that we see on X-rays (like worn-down bone, spurs, or a slipped disc). That's not to say that the mechanical problems should be ignored, but that the relief of pain and the opportunity for the joint to restore some degree of healing is dependent on reducing or eliminating inflammation. Most people employ over-the-counter drugs (like ibuprofen) and a host of prescription anti-inflammatories for osteoarthitic pain and disability. But these drugs are limited in their effectiveness, must be taken daily, and bring with them a variety of risks and side effects, including gastrointestinal irritation and interference with platelet functioning (which increases one's risk of bleeding).

By increasing the amount of anti-inflammatory proteins in the joint, Regenokine is aimed at addressing the inflammatory disease process. The "active ingredient" in the injections is Interleukin-1 receptor antagonist (IL-1 Ra), a natural substance in our bodies. Introducing it back into the body that produced it is called an "autologous" treatment. The body should not reject it because it is recognized as its own. 

***

It was back in July of 2008 that I first stepped off of a Lufthansa airlines flight and entered customs in Dusseldorf, Germany, with my mother-in-law and sister-in-law, to begin a week's treatment with what was then called Orthokine. I was there to have the treatment in both my knees; my mother-in-law was to have it in the one knee that surgeons back home said was in need of replacement.

We were two in a long string of orthopedic pilgrims who had come to see "The Professor" in this university town near Cologne, close to where Germany borders Holland and Belgium. Quietly, below the radar, scores of American athletes, celebrities, and health professionals (as well as others from nations around the world) had come to Professor Peter Wehling's clinic then on Königsallee, a charming urban boulevard with an unending canopy of trees and a canal rushing down the center, to look into this treatment that was not available anywhere else in the world. I had referred two of my own patients for his evaluation and was now about to be a patient myself.

I had sent digital images of X-rays and MRIs of my mother-in-law's and my knees in advance of our evaluation in Germany. Dr. Wehling looked at the films and reports and wrote back saying my arthritic knees had about a 70 percent chance of a response that could last two to three years (which might then respond again to another course of treatment). He said my mother-in-law had stage 3 arthritis and that the treatment might help for a year. So we decided to try.

On our first day in Dusseldorf, we went to Dr. Wehling's offices. Our consultation then began with a meeting in Dr. Wehling's office. Wehling speaks fluent German, French, and English, and some Spanish and Italian. He explained the procedure, was modest but confident about the success of his treatment, and invited questions and discussion. We then had blood drawn, about 100 cc (a bit less than three ounces), and were given a precise time to return the next day and the three days thereafter for our treatments.

While we walked about Dusseldorf and explored the beer gardens, the lab technicians were at work with our blood samples. A naturally occurring anti-inflammatory protein in everyone's blood (but unique in its composition in each person) was isolated from our samples and processed by a technique that Wehling developed. Our respective proteins were replicated thousands of times overnight (work is underway, today, to achieve same-day replication, which will shorten the time needed for the treatment). 

By the time we returned the next day, each of our individual anti-inflammatory proteins were in a concentrated solution and ready to be injected into our joints. My mother-in-law and I received daily injections into our knees of our naturally produced -- but now highly aggregated -- protein. The shots resemble those that orthopedists and primary care doctors give in the United States, except that their syringes are loaded with steroids (or some other substance aimed at providing limited and short-term relief and which is generally covered by insurance in the United States).

The procedure took less than 15 minutes. We left to explore the town, travel by train in the region, but always to return, on time, for the next day's appointment. There were no restrictions on movement. The experience was more of being a tourist than a patient.

Six weeks later, I was on a 10-day hike, carrying weight, like I couldn't for many years prior. 

For me, the treatment effect lasted about 3 years, during which I continued to exercise more than the normal person (but I had given up impact and torque sports like basketball, tennis, and downhill skiing years earlier). For my mother-in-law, she had significant relief but did require a knee replacement one year later. She has done quite well with a new knee.

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Lloyd Sederer, M.D., is medical director of the New York State Office of Mental Health and adjunct professor at the Columbia University Mailman School of Public Health. His book, The Family Guide to Mental Health Care, will be published in early 2013.

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