How new blood test could help

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A new blood test helps many to diagnose osteoarthritis. Aleksandar Nakic/Getty Images
  • Researchers say a new blood test that uses biomarkers could help improve the diagnosis of knee osteoarthritis.
  • They add that the new test could help diagnose osteoarthritis more quickly, allowing treatments to begin earlier.
  • Experts say it can also help manage the unpredictability of knee osteoarthritis.

Researchers at Duke University in North Carolina say a new blood test is more accurate in diagnosing the progression of osteoarthritis of the knee than current methods.

They say the new test could help advance research and speed the discovery of new therapies for a disorder that currently lacks effective treatments.

Researchers say doctors have lacked a reliable method to accurately identify and predict the risk of osteoarthritis progression, resulting in an inability to include the right subjects in clinical trials to test therapies.

Their study was published today in the journal Science Advances.

“Treatments are lacking, but it’s difficult to develop and test new therapies because we don’t have a good way to determine the right patients for the therapy,” said Dr. Virginia Byers Kraus, the study’s lead author and professor of medicine, pathology and orthopedic departments at Duke University School of Medicine, in a statement.

Kraus described the situation as “the chicken-and-egg predicament.”

“In the immediate future, this new test will help identify people at high risk for progressive disease—those likely to have both pain and worsening injuries identified on X-rays—who should be enrolled in clinical trials,” she added. “Then we can learn whether a therapy is beneficial.”

Osteoarthritis is the most common joint disorder in the United States.

That affects 13% of women and 10% of men over the age of 60 and is a major cause of disability.

The research team said it isolated more than a dozen molecules in the blood that were associated with the development of the disease.

Researchers eventually narrowed the blood sample down to a set of 15 biomarkers corresponding to 13 proteins. They reported that the markers accurately predicted 73% of progressors from non-progressors among 596 people with knee osteoarthritis.

Dr. Stella Bard, a rheumatologist in New York City, told Healthline she was impressed by the study’s numbers.

“That’s a great percentage,” Bard said. “It just seems that research treatment for this condition never works. And the way we diagnosed it now, by X-rays, is not very accurate. It doesn’t really correlate with symptoms.”

Bard told Healthline that osteoarthritis is different from rheumatoid arthritis in that “we have so many useful disease-modifying agents or treatments for the condition that are also effective in other inflammatory arthritis.”

“Right now, all we can recommend is turmeric, omega 3, Tylenol and chondroitin, NSAIDS (non-steroidal anti-inflammatory drugs), lidocaine, and intra-articular injectables like hyaluronic acid, PRP, and steroids,” she added.

The important question is what comes next, said Dr. Alan Beyer, the executive medical director of the Hoag Orthopedic Institute in Irving, Calif., told Healthline.

“My first reaction is OK, now what?” Beyer told Healthline. “Once you’ve confirmed it, either through imaging, clinical experience or a new blood test, what now?”

He noted that diagnosing osteoarthritis of the knee is fairly standard practice for any orthopedic surgeon.

“Imaging today tells us a lot,” Beyer said. “Years of clinical experience with patients in the examination room reveal even more. A blood test to confirm your diagnosis would be good, but at what cost to the patient?”

Beyer said the blood test is a better tool for researchers than the doctors who treat people with osteoarthritis.

“I don’t think it’s a game changer for most practicing orthopedic surgeons, but it could be an asset for academics or researchers to use to study therapies for a drug to treat osteoarthritis,” he added.

Dr. Joshua Carothers is a fellow of the American Academy of Orthopedic Surgeons and chief physician for the mobile health service VIP StarNetwork.

Carothers said current osteoarthritis treatments don’t address causes as much as they do effects. Carothers told Healthline that an accurate blood test could help change that.

“There are current treatments for osteoarthritis. But they are primarily aimed at addressing symptoms such as pain, swelling and disability associated with the progression of the disease,” Carothers said. “Often this culminates in a joint replacement procedure. These are effective against the symptoms, but it would be correct to say that we do not have a treatment that is effective in stopping or reversing the disease process in osteoarthritis.”

He added that osteoarthritis is multifactorial, involving complicated tissues, enzymatic processes, and underlying etiologies.

“Currently, there are no commonly available molecular or blood test modalities available to inform the average clinician or orthopedist about the degree of arthritis or its likelihood of progression,” Carothers said. “Our testing methods primarily involve the patient’s history and physical exam, X-rays, and more advanced imaging such as magnetic resonance imaging. (MRIs) are expensive and time-consuming, and it’s not an effective way to follow osteoarthritis.”

Carothers said a blood test with 73% accuracy could help address the unpredictability of osteoarthritis.

“There would certainly be a lot of interest in a blood test that could accurately describe the current status of the cartilage and the likelihood of arthritis developing over a certain time frame,” he said. “Further useful information would be that which would allow prediction of which treatments would be most effective in different patients.

“Osteoarthritis is certainly unpredictable in patients; it can be relatively stable for years in some, while in others it can progress quite rapidly. This information would be quite useful for both patients and clinicians in terms of planning future treatment,” Carothers added.

How new blood test could help

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