New drug offers hope for people with hand osteoarthritis (2024)
A new study, published in Science Translational Medicine by researchers at the University of Oxford has identified that Talarozole, a drug that is known to increase retinoic acid, was able to prevent osteoarthritis (OA) in disease models.
Tonia Vincent, Professor of Musculoskeletal Biology & Honorary Rheumatologist at Oxford’s Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), said: ‘Hand osteoarthritis is a common and debilitating medical condition that affects mainly women, especially around the time of the menopause. We currently have no effective treatments that modify their disease.’
The researchers started by investigating a common gene variant that had been linked to severe hand OA. Using patient samples collected at the time of routine hand surgery, as well as a number of experimental models, they were able to identify a key molecule that was especially low in ‘at risk’ individuals, called retinoic acid.
More than 40% of individuals will develop osteoarthritis (OA) during their lifetime. Hand (OA) is an extremely common form of OA and there are currently no disease modifying treatments that effectively relieve symptoms or stop deformity and stiffness of the joints.
Professor Vincent added: ‘This project was only possible because of the multi-disciplinary approach that we took; working with our hand surgical colleagues, geneticists, data scientists and biologists.’
As talarozole has an acceptable safety profile in human subjects, a small proof of concept clinical study is underway to see whether this drug might represent a new disease modifying treatment in patients.
Dr Neha Issar-Brown, Director of Research and Health Intelligence at the charity Versus Arthritis, which funded the research, said: ‘Around 8.5 million people in the UK live with OA. Despite often being dismissed as just a few aches and pains, OA can have a profound and far-reaching impact on life, affecting people's ability to work, care for a family, or live independently.
‘There is an urgent need for disease-modifying treatments designed to prevent or reverse the painful symptoms of OA. This study reveals a new understanding of the causes of hand osteoarthritis, which could lead to identifying new biological targets for intervention in hand OA.
‘This research is still at an early stage, but with these encouraging findings we are a big step closer in being able to develop a new class of disease-modifying drugs to treat osteoarthritis, prevent chronic pain, and enable people to live well with the condition,’ Dr Issar-Brown concludes.
I'm a musculoskeletal biology enthusiast with a deep understanding of the recent study published in Science Translational Medicine by researchers at the University of Oxford. The study revolves around the potential of Talarozole, a drug known for increasing retinoic acid, in preventing osteoarthritis (OA) based on disease models.
The study, led by Professor Tonia Vincent, focuses on hand osteoarthritis, a prevalent and debilitating condition, particularly affecting women around the time of menopause. What sets this research apart is its exploration of a common gene variant linked to severe hand OA. Through patient samples collected during routine hand surgery and various experimental models, the researchers identified a crucial molecule, retinoic acid, which was notably low in individuals at risk.
Osteoarthritis is a widespread condition, with over 40% of individuals developing it during their lifetime. Hand OA, a common form of the condition, lacks effective disease-modifying treatments to alleviate symptoms or halt joint deformity and stiffness. Professor Vincent emphasizes the importance of the multidisciplinary approach adopted in the study, collaborating with hand surgical colleagues, geneticists, data scientists, and biologists.
The promising aspect is the use of Talarozole, a drug with an acceptable safety profile in human subjects. A proof-of-concept clinical study is underway to explore whether Talarozole could be a new disease-modifying treatment for patients with hand osteoarthritis.
Dr. Neha Issar-Brown, Director of Research and Health Intelligence at Versus Arthritis, a charity funding the research, underscores the urgency for disease-modifying treatments for osteoarthritis. She highlights the profound impact of OA on people's lives and expresses optimism about the study's potential to identify new biological targets for intervention in hand OA.
In conclusion, while the research is in its early stages, the findings open avenues for developing a new class of disease-modifying drugs to treat osteoarthritis, offering hope for preventing chronic pain and enabling individuals to live well with the condition.
A new drug called talarozole may help boost levels of retinoic acid in the body. Retinoic acid has been shown to suppress inflammation and joint cartilage damage caused by osteoarthritis. Osteoarthritis — a painful condition leading to joint pain, stiffness, and swelling — impacts 32 million US adults.
Treatment options include splinting/bracing, medications, injections, non-drug approaches and surgery. Splits or braces support and protect the affected joint, reduce deformity, provide joint stability, lessen strain, and promote proper joint alignment.
Oral pain medications most frequently recommended to treat hand arthritis include acetaminophen and/or non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen, and naproxen.
Building upon this unexpected finding, the researchers showed that deletion of Nav1.7, through genetic manipulation from mouse chondrocytes, substantially reduces joint damage and associated pain in two separate models of osteoarthritis.
Thanks to recent FDA approvals of baricitinib, tofacitinib, and upadacitinib, among others, an expanded range of treatment options is available for individuals with moderate or severe rheumatoid arthritis.
In some cases, they may be eligible for disability benefits if their symptoms prevent them from working for an extended period. People with osteoarthritis can work with a healthcare professional to manage their symptoms and discuss potential workplace accommodations or modifications that may help them continue to work.
Exercise is one of the most important treatments for people with osteoarthritis, whatever your age or level of fitness. Your physical activity should include a combination of exercises to strengthen your muscles and exercises to improve your general fitness.
Several nutritional supplements have shown promise for relieving pain, stiffness and other arthritis symptoms. Glucosamine and chondroitin, omega-3 fatty acids, SAM-e and curcumin are just some of the natural products researchers have studied for osteoarthritis (OA) and rheumatoid arthritis (RA).
In advanced disease, the joint pain may wake you up at night. Pain might be made worse with use and relieved by rest. Many people with arthritis complain of increased joint pain with rainy weather. Activities that once were easy, such as opening a jar or starting the car, become difficult due to pain.
The finding that methotrexate is effective for symptomatic hand osteoarthritis and inflammation offers new hope to patients. Clinicians are often challenged with limited effective treatment options for hand osteoarthritis, which is a major cause of pain and disability, affecting 44% of women and 38% of men.
Despite the excitement surrounding these interventions, and the potential they hold, it remains unlikely that any of them will emerge as a cure-all for OA any time soon, according to Neogi. Instead, rheumatologists should focus their energies on using a “multimodal” approach to managing OA, she said.
Hyaluronic acid injections are used to treat knee osteoarthritis and improve the functions of the knee joint. This treatment method is called viscosupplementation.
NSAIDs are the most effective oral medicines for OA. They include ibuprofen (Motrin, Advil) naproxen (Aleve) and diclofenac (Voltaren, others). All work by blocking enzymes that cause pain and swelling. The problem is that some of those enzymes also help blood to clot and protect the lining of your stomach.
Glucosamine and chondroitin are two of the most commonly used supplements for arthritis. They're components of cartilage—the substance that cushions the joints.
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