Platelet-derived growth factor compositions and methods for the treatment of tendinopathies
Provided herein are compositions and methods for the treatment of tendinopathies, such as tenosynovitis, tendinosis or tendinitis, including Achilles tendinopathy, patellar tendinopathy, lateral epicondylitis or “tennis elbow,” medial epicondylitis or “golfer's elbow,” plantar fasciitis, and rotator cuff tendinopathy, and in particular to methods for the treatment of tendinopathies by administering compositions comprising platelet-derived growth factor (PDGF).
1. A method of treating a tendinopathy comprising administering to an affected tendon an effective amount of a composition comprising a solution of PDGF in a buffer, wherein the effective amount of the composition comprises between about 75 μg and about 7,500 μg of PDGF per dose, wherein the administration to an affected site comprises direct injection into the affected tendon, and further wherein the tendon is chosen from the extensor hallucis longus, the flexor hallucis longus, the extensor digitorum longus, the extensor digitorum brevis, the peroneus longus, the peroneus brevis, the flexor hallucis brevis, the flexor digitorum longus, the posterior tibialis, the Achilles tendon, the plantar fascia, patellar tendon, the anterior tibialis tendon, the hamstring tendon, the semitendinosus tendon, the gracilis tendon, the abductor tendon, the adductor tendon, the flexor tendon, the rectus femoris tendon, the tibialis posterior tendon, the quadriceps femoris tendon, the biceps tendon, the triceps tendon, the extensor carpi radialis brevis, the common extensor tendon, the extensor digitorum, the extensor digiti minimi, the extensor carpi ulnaris, the supinator, the common flexor tendon, the pronator teres, the flexor carpi radialis, the palmaris longus, the flexor carpi ulnaris, the digitorum superficialis, the flexor pollicis brevis, the flexor pollicis longus, the abductor pollicis brevis, the abductor pollicis longus, the flexor digitorum profundus, the flexor digitorum superficialis, the extensor pollicis brevis, and the extensor pollicis longus.
2. The method of claim 1 , wherein the tendinopathy is a tendinosis.
3. The method of claim 1 , wherein the tendinopathy is a tendinitis.
4. The method of claim 1 , wherein the tendinopathy is a tenosynovitis.
5. The method of claim 1 , wherein the PDGF is selected from the group consisting of PDGF-AA, PDGF-BB, PDGF-AB, PDGF-CC, and PDGF-DD.
6. The method of claim 1 , wherein the PDGF comprises PDGF-BB.
7. The method of claim 6 , wherein the PDGF-BB comprises recombinant human (rh) PDGF-BB.
8. The method of claim 6 , wherein the effective amount of the composition comprises between about 75 μg and about 7,500 μg of PDGF-BB per dose.
9. The method of claim 6 , wherein the effective amount of the composition comprises between about 500 μg to about 1,000 μg of PDGF-BB per dose.
10. The method of claim 6 , wherein the effective amount of the composition comprises between about 5,000 μg to about 7,500 μg of PDGF-BB per dose.
11. The method of claim 6 , wherein the effective amount of the composition comprises between about 450 μg to about 3000 μg of PDGF-BB per dose.
12. The method of claim 6 , wherein the effective amount of the composition comprises between about 400 μg to about 1000 μg of PDGF-BB per dose.
13. The method of claim 6 , wherein the effective amount of the composition comprises between about 500 μg to about 900 μg of PDGF-BB per dose.
14. The method of claim 6 , wherein the effective amount of the composition comprises between about 600 μg to about 800 μg of PDGF-BB per dose.
15. The method of claim 6 , wherein the effective amount of the composition comprises between about 650 μg to about 750 μg of PDGF-BB per dose.
16. The method of claim 6 , wherein the effective amount of the composition comprises about 700 μg of PDGF-BB per dose.
17. The method of claim 1 , wherein the composition has a volume of about 1.0 to about 2.0 ml per dose.
18. The method of claim 1 , wherein the composition has a volume of about 1.5 ml per dose.
19. The method of claim 1 , wherein the buffer is selected from the group consisting of phosphate-buffered saline, sodium acetate, ammonium acetate, acetic acid, citric acid, sodium citrate, tris(hydroxymethyl)aminoethane, N-2-hydroxyethylpiperazine-N′-ethanesulfonic acid, 3-(N-morpholino) propanesulfonic acid, 2-(N-morpholino)ethanesulfonic acid, N-(2-acetamido)iminodiacetic acid, piperazine-N,N′-bis(2-ethanesulfonic acid), and N-(2-acetamido)-2-aminoethanesulfonic acid.
20. The method of claim 19 , wherein the buffer is sodium acetate.
21. The method of claim 1 , wherein the composition is administered using a peppering technique, wherein the needle is inserted into the affected tendon and multiple small injections are performed by withdrawing, redirecting and reinserting the needle into the tendon without the needle to emerging from the skin.
22. The method of claim 1 , wherein the composition is administered once a week for up to six months.
23. The method of claim 1 , wherein the composition is administered twice a month for up to six months.
24. The method of claim 1 , wherein the composition is administered once a month for up to six months.