Chronic Low Back Pain (CLBP) Associated with Modic Changes (MCs)

CLBP is defined as persistent or fluctuating low back pain lasting at least three months. It is a disabling and costly condition that is associated with increased healthcare utilization.

The economic costs of CLBP are estimated to range from $12.2 billion to $90.6 billion annually in the United States. Factors that contribute to this economic impact include prolonged loss of function, consequent loss of work productivity, treatment costs, and disability payments.

Some patients with CLBP exhibit MCs. MCs are vertebral bone marrow changes that are visible on MRI of the spine, and that are associated with low back pain, based on published studies. Findings from various studies have demonstrated that the presence of MCs, especially type 1 MCs, is correlated with low back pain, predicts persistent symptoms, and sick leaves, and is associated with poor outcomes. These findings suggest that MCs are a potential target for pharmaceutical intervention.

Knee OA Associated with Bone Marrow Lesions (BMLs)

Knee OA is a disorder characterized by bone changes around the knee joint, progressive loss of joint cartilage, joint space narrowing, and eventual total joint failure. Knee OA results in knee pain, significant physical disability, and reduced quality of life.

Some patients with knee OA exhibit BMLs. BMLs appear as areas of increased signal intensity on MRI of the knee, and are associated with and predict knee pain, disease severity, and structural progression in patients with knee OA, based on published studies. BMLs may therefore be a source of knee pain and a potential target for pharmaceutical intervention.