Osteoarthritis Treatment Should Align with Disease Subtypes

A new study published by the Annals of the Rheumatic Diseases suggests that a majority of patients with osteoarthritis (OA) can be grouped into 2 distinct subtypes.

The study authors discovered 2 different patterns of disease activity among patients with OA, which may have an impact on diagnosis and future drug development.

“This is an important new discovery in osteoarthritis, which reveals a metabolic basis for developing patient specific treatments targeted at the two different groups,” said Tim Hardingham, PhD, DSc. “It will inform the future design, set up and analysis of drug trials and may help predict different patient responses to treatment.”

Currently, all patients with OA receive similar treatments, regardless of subtypes, according to the study. Inadequate therapy can result in poor quality of life, limited mobility, and worsened symptoms.

“The disease has many clinical criteria and treating it as a single disease has become recognized [sic] as unproductive,” Dr Hardingham said.

The authors said these findings may help predict treatment response because the analysis was based on active metabolism in disease tissue.

“There is an urgent need for better treatments and we hope this research may help us along that road,” Dr Hardingham said.

The novel discovery was the result of a mathematical analysis that included thousands of genes expressed from 60 patients with knee OA. The study indicated that there are 2692 differently expressed genes between OA and non-OA tissue, according to the authors.

The authors also developed a list of candidate biomarkers in patients’ synovial fluid, which may help identify which group a patient falls into.

“This is a significant step forward in our understanding of osteoarthritis, a complex and debilitating disease which has a major socio-economic impact,” Dr Hardingham said. “However, the discovery is just the first step in a long process that may lead to developing new drugs and treatments that are targeted to each group.”

The authors noted that these results could be used to develop more targeted treatments for both groups of patients with OA. These therapies may prevent progression and improve health outcomes, according to the study.

“So any new treatments which delayed the onset, or reduced progression of osteoarthritis in either group, would relieve much patient suffering and reduce the healthcare burden,” Dr Hardingham said.