Palovarotene Inhibits Heterotopic Ossification and Maintains Limb Mobility and Growth in Mice With the Human ACVR1(R206H) Fibrodysplasia Ossificans Progressiva (FOP) Mutation

J Bone Miner Res. 2016 Sep;31(9):1666-75. doi: 10.1002/jbmr.2820. Epub 2016 Mar 12.


Fibrodysplasia ossificans progressiva (FOP), a rare and as yet untreatable genetic disorder of progressive extraskeletal ossification, is the most disabling form of heterotopic ossification (HO) in humans and causes skeletal deformities, movement impairment, and premature death. Most FOP patients carry an activating mutation in a bone morphogenetic protein (BMP) type I receptor gene, ACVR1(R206H) , that promotes ectopic chondrogenesis and osteogenesis and, in turn, HO. We showed previously that the retinoic acid receptor γ (RARγ) agonist palovarotene effectively inhibited HO in injury-induced and genetic mouse models of the disease. Here we report that the drug additionally prevents spontaneous HO, using a novel conditional-on knock-in mouse line carrying the human ACVR1(R206H) mutation for classic FOP. In addition, palovarotene restored long bone growth, maintained growth plate function, and protected growing mutant neonates when given to lactating mothers. Importantly, palovarotene maintained joint, limb, and body motion, providing clear evidence for its encompassing therapeutic potential as a treatment for FOP. © 2016 American Society for Bone and Mineral Research.


Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Activin Receptors, Type I / genetics*
  • Animals
  • Bone and Bones / abnormalities
  • Bone and Bones / pathology
  • Cell Proliferation / drug effects
  • Chondrocytes / drug effects
  • Chondrocytes / pathology
  • Disease Models, Animal
  • Disease Progression
  • Extremities / growth & development*
  • Extremities / physiopathology*
  • Growth Plate / drug effects
  • Growth Plate / pathology
  • Homeostasis
  • Humans
  • Mice, Transgenic
  • Movement
  • Mutation / genetics*
  • Myositis Ossificans / genetics*
  • Ossification, Heterotopic / drug therapy*
  • Ossification, Heterotopic / pathology
  • Ossification, Heterotopic / physiopathology*
  • Osteogenesis
  • Pyrazoles / pharmacology
  • Pyrazoles / therapeutic use*
  • Stilbenes / pharmacology
  • Stilbenes / therapeutic use*


  • Pyrazoles
  • Stilbenes
  • Palovarotene
  • Activin Receptors, Type I