Early biomarkers for ARthritic PAIN to guide improved treatments
Research type
Research Study
Full title
Early biomarkers for ARthritic PAIN to guide improved treatments for arthritis (ARPAIN) study
IRAS ID
234659
Contact name
Nidhi Sofat
Contact email
Sponsor organisation
St George's, University of London
Duration of Study in the UK
5 years, 2 months, 4 days
Research summary
Osteoarthritis (OA) is the most common type of arthritis worldwide and affects more than 8 million people in the UK. Many people with OA suffer from chronic pain and reduced function, costing the NHS millions of pounds every year. There are currently no good clinical tests to guide effective OA treatment and no therapies which slow down or cure the disease. There is an urgent need to identify markers of OA that can stratify patients for selective treatments and follow the efficacy of those treatments such that the disease can be appropriately managed. Bone marrow lesions (BMLs) are caused by increased pressure on the OA joint and can be identified by non-invasive MRI. Their presence in joints correlates with the pain experienced in OA. We have taken a novel approach combining MRI and clinical assessment of pain with gene expression profiling. We have identified a number of differentially-expressed genes in BMLs from OA patients, compared to normal bone from healthy individuals. A number of these genes have not been linked with OA before but are involved in new nerve formation, pain sensitisation, bone turnover and cartilage renewal. We have confirmed the expression of these genes at the protein level and have found some to be present in blood and urine from patients with OA, suggesting diagnostic potential in the future. In this proposal, we aim to evaluate the markers we have identified in a large UK-wide study and further correlate their expression with MRI so that stratified treatments can be developed for specific OA phenotypes. We have found biomarkers that correlate with structural damage, and another which correlates with pain. We propose that our new biomarkers can be used to develop targeted treatments for OA e.g. bone modulators for structural damage and pain modulators for people with high pain biomarkers.[COVID-19 amendment – 22/04/2020] Requesting a substantial amendment to our existing ARPAIN study for a Covid-19 sub-study arm to assess coronavirus infection and presence of antibodies in the blood of patients who are on immunomodulatory drugs that have been implicated in the treatment of Covid-19.
REC name
London - Surrey Research Ethics Committee
REC reference
17/LO/1894
Date of REC Opinion
18 Dec 2017
REC opinion
Further Information Favourable Opinion