A curious study recently concluded with disappointing results for the concerned company. The company and it's odd business approach was discussed in In The Pipeline. CombinatoRx, combines already improved drugs into a single product, hopefully with synergistic effects. The drug they were investigating was Synavive, a combo of prednisolone and dipyrimadole. The hope was that the dipyrimadole would allow for lower doses of prednisolone in the treatment of inflammatory disease. Oddly, the disease they chose was osteoarthritis of the knee, a condition which is not usually treated with oral prednisolone. When it is treated with corticosteroids, it's usually with a dose of 40mg of long acting prednisolone injected directly into the knee joint, and even then the results are far from spectacular. The dose chosen for this study was a paltry 2.7 mg. Even if the dipyrimadole were to double the effect of the prednisolone, I would not expect it, from clinical experience, to be effective. As it turns out, neither the prednisolone 2.7 nor the combinations were of any use. It seems that the company did have some earlier preliminary results with OA as well as rheumatoid arthritis. Why they chose the prior, when it's the rheumatoid patients that might logically benefit from this kind of treatment, is not at all clear. I suspect it's because any RA patient with disease active enough to take prednisone was already locked into a biologic drug study. And now that this study was such a bust, we'll probably never see a disease appropriate trial in the future.