Trevor P Scott MD
UCLA Orthopedic Surgery Resident
Dr. Farad Parhami PhDDr. Jeff Wang MDDr. Michael Daubs MDDr. Scott Montgomery MDDr. Akinobu Suzuki MDDr. Haijun Tian MDDr. Jared Johnson MDMr. Kevin Phan BSDr. Elisa Atta PhDDr. Sotirios Tetratis MDDr. Renata Pereira MD
A Comparison of a Novel Oxysterol Molecule to rhBMP2 in a Rabbit Posterolateral Fusion ModelTrevor Scott MD
My disclosure is in the Final Program and in the AAOS Orthopaedic Disclosure program.
Dr. Parhami discloses that he is a founder of MAX BioPharma Inc., which has licensed the rights to Oxy133
from UCLA, and that he has financial interests in the technology presented here. In addition, as part of the
licensing agreement, UCLA holds equity in MAX BioPharma. All other authors state that they have no
conflicts of interest.
Background Pseudarthrosis is a potential complication of major
spinal surgery and fracture surgeries
Iliac crest autografts, which remain the standard of care, have substantial donor site morbidity and may not provide enough graft volume for large surgeries
Biologics are an active area of research to find the best possible alternative to iliac crest autograft
Background rhBMP2 was approved in
2002 for single level lumbar fusion and its use spread rapidly
Recently concerns about possible complications of rhBMP2 have increased
Background Our lab has previously synthesized a compound,
oxysterol 133 (Oxy133), which showed promise as a biological adjunct to fusion
Equivalent to rhBMP2 in rat posterolateral fusion model
In vitro promotes significant osteogenic marker expression including Runx2, osterix, alkaline phosphatase, bone sialoprotein and osteocalcin
Purpose To compare the efficacy of rhBMP2 and oxysterol 133 in
a rabbit posterolateral lumbar fusion model
Methods In vitro study
24 rabbits underwent bilateral posterolateral lumbar fusion at L4-5
Groups: control (A), 30 ug rhBMP2 (B), 20 mg oxysterol 133 (C), 60 mg oxysterol 133 (D)
Fusion evaluated by fluorscopy at 4 weeks and by faxitron radiograph, microCT and manual palpation after sacrifice at 8 week
Figure 1
0% 50% 100% 150%
*
* Indicates p < 0.05 compared to group A (Control)
% Fusion
*
**
**
Control
30 mg BMP2
20 mg Oxy133
60 mg Oxy133
Figure 2
Control 30 µg BMP2 20 mg Oxy133 60 mg Oxy133Control 30 µg BMP2Control 30 µg BMP2Control 20 mg Oxy13330 µg BMP2Control 60 mg Oxy13320 mg Oxy13330 µg BMP2ControlControl 30 µg BMP2Control 20 mg Oxy13330 µg BMP2Control 60 mg Oxy13320 mg Oxy13330 µg BMP2Control
Fusion by Manual Palpation at 8 weeks
0% 20% 40% 60% 80% 100%
A
B
C
D
Fusion Rate*
* Indicates p < 0.05 compared to group A
% Fusion
*
*
Fusion Assessment by microCT
0% 20% 40% 60% 80% 100%
A
B
C
D
CT Lumbar SpinalFusion
* Indicates p < 0.05 compared to group A
% Fusion
*
*
*
Figure 5
60 mg Oxy13320 mg Oxy13330 µg BMP2Control
Fusion Rate Summary
Fusion Mass TV on microCT
0 500 1000 1500 2000 2500
Control
BMP2
Oxy 20
Oxy 60
Tissue Volume (mm^3)
Tissue Volume(mm^3)
*
*
*
* Indicates p<0.5 compared to control
Figure 6
60 mg Oxy13320 mg Oxy13330 µg BMP2Control
Conclusions High dose and lose dose oxysterol 133 show equivalent
fusion to rhBMP2,
Given its osteogenic potency, anticipated lack of immunogenicity, and low cost of production, Oxy133 may be an excellent alternative to rhBMP2 for spinal fusion procedures and is worthy of further study
Thank You
Dr. Farad Parhami PhD Dr. Jeff Wang MD Dr. Michael Daubs MD Dr. Scott Montgomery MD Dr. Akinobu Suzuki MD Dr. Haijun Tian MD Dr. Jared Johnson MD Kevin Phan BS Dr. Elisa Atta PhD Dr. Sotirios Tetratis MD Dr. Renata Pereira MD
Special thanks to:Allison Roe BSTaylor Hobson BS
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