Uncovering the bare bones of osteoarthritis

Tuesday, 18 February, 2014
Creaking joints, knotty hands, swollen knees… as we grow older, many of us will become acquainted with these symptoms of osteoarthritis, the most common form of arthritis. EU funding has helped researchers at the TREAT-OA project add to our knowledge of the disease and opened up new avenues for prevention, diagnosis and treatment.
Osteoarthritis, a degenerative disease that affects the joints, is very common indeed – and for patients who develop serious symptoms, it can turn even the simplest tasks of everyday life into a painful challenge.

This degenerative illness is characterised by the progressive erosion of the cartilage at the end of the bones. As a result of this damage, the bones rub against each other, causing pain and potentially deforming the joint.

World Health Organization figures place it among the 10 most disabling diseases in developed countries. One in three over-65s can expect to develop this disease, to varying degrees.

Unfortunately, there is no cure. Treatment options focus primarily on prevention and on the management of symptoms. Painkillers and anti-inflammatory drugs are widely used, and severe cases may call for surgery.

Are you at risk?

“The biggest predictor of osteoarthritis is age,” says Dr Ana Valdes of King’s College London, “the second is gender, and the third is obesity.”

Women over 65 carrying significant excess weight top the list of potential sufferers. This, however, does not mean that trim young men are necessarily in the pink. Osteoarthritis is strongly associated with wear and tear. Accidents and repetitive stress add to the risk.

That said, these aspects are only part of the puzzle, as there are also genetic factors involved. Genetic make-up, says Dr Valdes, contributes more prominently to the occurrence of osteoarthritis in younger patients.

Age, gender, weight … and more

Dr Valdes was the scientific coordinator of the TREAT-OA project, which was launched in 2008. It involved 11 partners from 6 European countries, collaborating with a wider network extending around the world.

TREAT-OA enabled the partners to work together in extending the knowledge about genetic aspects influencing the onset and progression of the disease. They have jointly explored new ways of detecting the disease and predicting how it will progress, and shortlisted promising approaches for the development of drugs.

“Working at European level was very useful,” says Dr Valdes, “because it brought in study cohorts, know-how and clinical expertise that are not available in a single country.”

As one of its main outcomes, the project has helped to refine an existing test used to predict if individual osteoarthritis patients are likely to develop a severe form of the disease. Doctors can use the test results, combined with other medical information, to identify whether someone is at risk, with an accuracy of around 70%.

Another key finding underlines the importance of making an early diagnosis. Doctors often overlook early warning signs on x-rays pointing to the onset of osteoarthritis, at a stage where prevention might help to delay the progression of the disease and the appearance of symptoms, says Dr Valdes. Increased awareness alone could significantly reduce the burden on individuals and health care systems.

Unexpectedly, says Dr Valdes, the project team also came to explore genetic factors associated with pain.

“The genetic contribution to osteoarthritis is not just to the joint damage,” she explains, “but also to the pain that the patients experience.”

This insight opens up new opportunities to reduce pain and improve patients’ quality of life.

Improving prevention, diagnosis and care

TREAT-OA has strengthened the ties among osteoarthritis research teams across Europe and beyond. The partners are now planning to engage with other stakeholders, such as doctors and patients’ organisations.

They also plan to make contacts with networks focusing on related conditions – such as sarcopenia, the age-related degeneration of skeletal muscular mass, which is a contributing factor in osteoarthritis.

“I think we have done a lot, but there is still much to be done,” Dr Valdes concludes, stressing the need for long-term commitment to osteoarthritis research and the exploitation of its outcomes.

The scope to develop more effective treatment options is wide and potentially includes the development of drugs that could halt the progression of the disease. One day, it may be possible to stop osteoarthritis in its tracks.

Translational research in Europe applied technologies for osteoarthritis
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