- Researchers say a new blood test that uses biomarkers may help improve the diagnosis of knee osteoarthritis.
- They add that the new test could help diagnose osteoarthritis more quickly, allowing for treatments to begin earlier.
- Experts say it could also assist in dealing with knee osteoarthritis’ unpredictability.
Researchers at Duke University in North Carolina say a new blood test is more accurate in diagnosing the progression of osteoarthritis in the knee than current methods.
They say the new test could help advance research and speed up the discovery of new therapies for an ailment that currently lacks effective treatments.
Researchers say medical professionals have lacked a dependable method of accurately identifying and predicting 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.
“Therapies 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 a professor in the Medicine, Pathology and Orthopedic departments at Duke University School of Medicine, in a statement.
Kraus described the situation as the “chicken-and-the-egg predicament.”
“In the immediate future, this new test will help identify people with high risk of progressive disease – those likely to have both pain and worsening damage identified on X-rays – who should be enrolled in clinical trials,” she added. “Then we can learn if a therapy is beneficial.”
Osteoarthritis is the most common joint disorder in the United States.
The research team said it isolated more than a dozen molecules in the blood associated with the progression of the disease.
Researchers eventually narrowed the blood test 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 with the study’s numbers.
“That is an amazing percentage,” Bard said. “It just seems like 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 to symptoms.”
Bard told Healthline osteoarthritis is different from rheumatoid arthritis, for which “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 Hoag Orthopedic Institute in Irving, CA., told Healthline.
“My initial reaction is OK, now what?,” Beyer told Healthline. “Once you confirm it, either through imaging, clinical experience, or a new blood test, now what?”
He noted that diagnosing osteoarthritis of the knee is pretty standard practice for any orthopedic surgeon.
“Imaging today tells us a lot,” Beyer said. “Years of clinical experience with patients in the exam room reveals 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 treating people with osteoarthritis.
“I don’t think it’s a game changer for most practicing orthopedic surgeons, but it could be a benefit for academics or researchers to use to study therapies for a medication to treat osteoarthritis,” he added.
Dr. Joshua Carothers is a fellow for the American Academy of Orthopedic Surgeons and chief medical officer of mobile health service VIP StarNetwork.
Carothers said current osteoarthritis treatments don’t address causes as much as they do effects. Carothers told Healthline an accurate blood test could help change that.
“There are current treatments for osteoarthritis. However, they are aimed primarily at addressing the symptoms such as the pain, swelling, and disability associated with the progression of the disease,” Carothers said. “Oftentimes this culminates in a joint replacement procedure. These are effective for the symptoms, but it would be correct to say that we don’t have a treatment that is effective in halting or reversing the disease process of osteoarthritis.”
He added that osteoarthritis is multifactorial involving complicated tissue, enzymatic processes, and underlying etiologies.
“Currently, there are not widely available molecular or blood testing modalities available to inform the average clinician or orthopedist as to the degree of arthritis or its likelihood for progression,” Carothers said. “Our modalities for testing involve primarily the history and physical examination of the patient, radiographic examination, and more advanced imaging such as magnetic resonance imaging. (MRIs) are costly and time-consuming, and it’s not an efficient way of following osteoarthritis.”
Carothers said a blood test with an accuracy of 73% could help counter the unpredictability of osteoarthritis.
“Certainly, there would be great interest in a blood test that could accurately describe the current status of the cartilage and the likelihood for the arthritis to progress over a certain timeframe,” he said. “Additional helpful information would be that which would allow prediction as to which treatment modalities would be most effective in different patients.
“Osteoarthritis certainly does play out unpredictably in patients; it can be relatively stable for years at a time in some, while in others it can progress quite rapidly. This information would be quite helpful for patients and clinicians alike in terms of planning future treatment,” Carothers added.