Two major new clinical studies will help to improve the early diagnosis of osteoarthritis and investigate treatment options for children with a serious inflammatory condition called juvenile dermatomyosis.
Versus Arthritis, the UK’s largest charity dedicated to supporting people with arthritis, is investing £2.2 million in the projects, which it hopes will lay the foundations for faster and more accurate diagnoses in the future. This is important because arthritis is a degenerative condition, so the sooner it is diagnosed the sooner treatment can begin, helping to slow its development.
What are clinical studies?
A clinical study is a form of research that looks into new tests or treatments and evaluates their effects on the people who volunteer to take part in the trials.
What is osteoarthritis?
Osteoarthritis is the most common form of arthritis, affecting around 8.75 million people in the UK. It is a degenerative disease that starts with the roughening of cartilage, which is the tough rubbery substance that cushions the ends of the bones, allowing the joints of your body to move smoothly. Cartilage damage can lead to an increase in the amount of fluid inside the joint, causing it to swell and lose shape. Tiny spurs of bone can may form on the ends of the bone within the joint. Over time, this can result in joint damage, pain and stiffness. The joints most commonly affected are the knees, hands, hips and back.
A study into the earlier diagnosis of osteoarthritis
The first of the Versus Arthritis-funded studies will explore using new imaging techniques to diagnose osteoarthritis. Currently, X-rays are often used to confirm whether or not someone has osteoarthritis. However, an X-ray does not always reveal signs of the disease in its early stages, which means the diagnosis may be missed. This is a problem because osteoarthritis becomes more difficult to manage as the disease develops, so spotting it in the early stages is crucial for effective management. The sooner someone receives a diagnosis, the sooner clinicians can intervene to slow the development of more severe symptoms.
The new study, led by Professor Cosimo De Bari and his team at the University of Aberdeen will pioneering the use of a new type of imaging technology. It is similar to an MRI scan but has lower magnetic fields that change rapidly during the scanning process. This provides a more detailed picture than conventional MRI scans.
The study will target people aged between 35 and 70 who have knee pain and could be at risk of developing osteoarthritis. Participants will not have had previous knee surgery or known knee injuries and will show no signs of osteoarthritis on X-rays. Researchers will monitor the participants over a four-year period. They will use the new scans, alongside other tests such as blood tests and X-rays, to monitor for early signs of the disease. Participants with rapidly progressing osteoarthritis and those who have no changes in the amount of damage to the knee joint will be invited to undergo a knee biopsy to collect a small amount of synovium – the lining that surrounds the knee joint. Researchers will then test the tissue to assess how changes in the synovium might lead to joint damage.
The aim of the study is to help identify which patients should be receiving which treatments and when. By detecting osteoarthritis sooner, more people will get the right treatment at the right time.
A study into a new drug for children with juvenile dermatomyositis
Juvenile dermatomyositis (JDM) is a serious inflammatory disease that affects the muscles, blood vessels and organs of children who are affected. Although the condition is rare, better treatments are urgently needed. Currently, JDM is treated with steroids and methotrexate, but sadly this is not always effective.
A trial at University College London and Great Ormond Street Hospital, led by Professor Paul Brogan and his team, is investigating a potential new drug for JDM. Called baricitinib, the drug works by blocking Janus Kinase enzymes which are active in inflammatory disease. If the trial is successful, it could begin the process of making baricitinib widely available for the treatment of children with this serious condition. The potential impact on quality of life could be significant.
Specialists in arthritis diagnosis and treatment
Carrothers Orthopaedic specialises in diagnosing and treating all forms of arthritis, including providing joint replacement surgery.
A private patient at Nuffield Hospital Cambridge who recently underwent a total hip replacement with Mr Carrothers wrote on 16 August 2024 on the review site iwantgreatcare.org:
“At six weeks, I could go for a swim (no breaststroke), sit on an exercise bike and walk for short periods unaided (20 -30 mins). My gait feels normal and my well-being has lifted beyond measure.”
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