Osteoarthritis takes a major toll on quality of life. In addition to pain, stiffness, and loss of mobility, patients with this progressive disease are at risk of losing muscle tone, strength, and stamina. Patients with osteoarthritis often struggle with anxiety, depression, isolation, and financial difficulties as they lose their ability to work.1
In the quest to improve patient outcomes, top osteoarthritis experts are taking a 3-pronged approach to tackling this disease. These efforts target ways to prevent osteoarthritis, improve diagnosis, monitor disease progression, and evaluate treatment options.
Preventing Osteoarthritis by Identifying Disease Markers
Rather than prioritizing the treatment of osteoarthritis, numerous rheumatologists are focusing their research efforts on ways of preventing disease onset. Virginia Byers Kraus, MD, PhD, is a professor of medicine, pathology, and orthopedic surgery at Duke University School of Medicine in Durham, North Carolina. In her recent interview with Rheumatology Advisor, she noted that some of her osteoarthritis research focuses on identifying genetic contributors that increase an individuals’ risk of developing osteoarthritis. According to Kraus, “Very large studies have identified more than 80 genetic contributors to osteoarthritis… Several [of these genes cause] changes in growth factors, supporting a view that in part, osteoarthritis is a failure to adequately repair ongoing daily joint damage.”
Now that this mechanism has been identified, she says, “I work on biochemical markers and have found that a low level of biomarkers related to joint tissue synthesis predicts risk of osteoarthritis progression of the knee.”
Addressing osteoarthritis biomarkers is also a research focus for David T. Felson, MD, MPH, professor of medicine and epidemiology at Boston University Schools of Medicine and Public Health. Specifically, Dr Felson identifies biomechanical risk factor associated with osteoarthritis. He then tests biomechanical treatments in an effort to determine if addressing those risk factors can delay or prevent the onset of osteoarthritis. In 2019, Dr Felson received a National Institutes of Health P30 Center Grant to further his study of osteoarthritis. P30 Center Grants are awarded to researchers who collaborate on multidisciplinary, network research efforts in their areas of study.
Improving the Diagnostic Process
As osteoarthritis prevention research continues, experts are developing methods for establishing the diagnosis of this condition earlier. As osteoarthritis is a progressive disease, Dr Kraus says, early diagnosis and improved disease tracking are crucial “because it is very disabling and highly prevalent around the world and a major contributor to inability to engage in physical activity and, thereby, heart disease.”
Ali Guermazi, MD, PhD, professor of radiology and rheumatology at Boston University School of Medicine, has been working to improve the process of diagnosis of osteoarthritis. A board-certified radiologist, Dr Guermazi focuses on the use of magnetic resonance imaging (MRI) to diagnose and track the progression of osteoarthritis, as well as to identify structural risk factors for osteoarthritis. Dr Guermazi contributed to the development of several radiologic methods for assessing risk and progression of osteoarthritis in the knee and hip, including a technique for measuring joint space width, since this marker is an indicator of osteoarthritis progression.
Assessing Osteoarthritis Treatments
An integral approach to improved care in osteoarthritis is, of course, evaluating new and accepted treatment protocols. Dr Felson studies the efficacy of applying accepted rheumatologic disease treatments to patients with osteoarthritis. Jeffrey Katz, MD, MS, director of the Orthopaedic and Arthritis Center for Outcomes Research at Brigham and Women’s Hospital in Boston, Massachusetts, also studies treatment efficacy. Dr Katz’s work is of a comparative nature in that he studied patients with osteoarthritis and torn menisci, a common side effect of the disease, investigating whether surgery or rehabilitative therapy provide better recovery outcomes.
Dr Kraus is also interested in treatments for osteoarthritis; her work focuses on identifying new osteoarthritis therapies. “We have been working on [the study of] regenerative microRNA that humans share with limb-regenerating salamanders,” says Dr Kraus. MicroRNA are a class of noncoding ribonucleic acid, a substance present in all living cells, which are involved in regulating the ways genes express themselves.2 Dr Kraus chose to focus on this area of research because “we believe [the miRNA] hold promise as a future means of boosting the innate but insufficient regenerative capacity of the human joint.” If successful, her research could help to reverse existing disease damage in people with osteoarthritis, something that is not yet possible with current therapy.
Facing the Future
By tackling OA on all fronts, the experts profiled hope to reduce the impact of this progressive disease, which is currently the most prevalent form of arthritis in the United States.3 With research advances, patients with osteoarthritis can hope to see improvement in symptom management and limited disease progression, while gaining valuable tools to help delay disease onset.
- Osteoarthritis 3: impact on patients. Nursingtimes.net. https://www.nursingtimes.net/clinical-archive/long-term-conditions/osteoarthritis-3-impact-on-patients-28-02-2012/. Published February 28, 2020. Accessed September 13, 2020.
- O’Brien J, Hayder H, Zayed Y, Peng C. Overview of microRNA biogenesis, mechanisms of action, and circulation. Fronts Endocrinol. 2018;9:402.
- A national public health agenda for osteoarthritis: 2020 update. Centers for Disease Control and Prevention. https://www.cdc.gov/arthritis/docs/oaagenda2020.pdf. Accessed September 13, 2020.