Development of a Novel Therapeutic Agent for Osteoarthritis
Abstract
Osteoarthritis (OA) is a degenerative joint disease that is characterized by a progressive loss of cartilage, which causes stiffness, swelling, and pain. Nearly 10% of the world’s population suffers from OA, making it the most common form of arthritis and one of the most common pathological conditions. Veterans are twice as likely to suffer from OA as civilians. In the United States, over 27 million people are affected by OA, and this number is projected to climb steeply due to a rapidly aging population and increased obesity rates. Each year, over $185 billion is spent to treat OA globally, establishing this disease as a major burden on global health and economics. OA is a progressive disease that often starts from a joint injury, and there no treatments are currently available to slow the loss of cartilage. Instead, doctors focus on lifestyle modifications, pain management, and improvement of joint function, with the overall goal to delay joint replacement surgery. Initial therapies for those with mild OA include weight loss, physical therapy, and pain management using over-the-counter, non-steroidal, anti-inflammatory drugs. As the condition progresses to a moderate stage, opioid-based pain control is introduced, while continuing physical therapy and other exercises. If the disease progresses to a severe stage, injections into the joint space are used to increase joint mobility. Finally, if these treatments fail to lessen the pain, total joint replacement surgery is considered. Over 1 million knee and hip replacements are performed each year in the United States, at a cost of over $50 billion. Here we propose to validate and develop a potential new therapy for OA. This medicine would be injected into the joint to block a signal that drives cartilage loss. By intercepting a signal that sustains the development of OA, this could be the first medicine that prevents advancement of the disease instead of just treating the symptoms. The research described here directly addresses the Peer Reviewed Orthopaedic Research Program’s Surgical Care Focus Area (OA). If successful, it would identify a medicine that could improve the outcomes for patients affected by OA and/or post-traumatic OA. Some of the possible benefits include reduction in pain, increased mobility, and slowing and/or stopping of disease progression; these would likely occur in the weeks following the first injection, with additional proposed injections every other month resulting in further benefits. Although unlikely to occur when administered directly into the joint, it is possible the medicine could prevent the body’s immune system from properly fighting off infections or healing wounds. While the first potential application of this medicine would be OA, it could also potentially benefit Veterans and patients suffering from other diseases driven by the same signal, including hair loss, psoriasis, and rheumatoid arthritis. This potential treatment is 3 to 4 years away from clinical trials in humans. Service members develop OA earlier in life and more often than civilians, necessitating long-term care and often reducing their ability to serve. Moreover, Soldiers injured by roadside bombs or other blast-related injuries often develop OA within 2 years, or 5X faster than civilians suffering injuries. OA is the most common condition that renders Soldiers unfit for duty, thereby decreasing morale and readiness. If successful, this medicine could greatly reduce the burden and progression of OA in Soldiers, thereby improving their lives and those of their families and caregivers. Importantly, these potential benefits would also apply to the general public, making the identification of groundbreaking new medicines for OA a priority.
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Oct 29, 2018
- Source ID
- W81XWH1810511
Entities
People
- Denis Evseenko
Organizations
- United States Army
- University of Southern California