How the new blood test can help

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A new blood test is very helpful in diagnosing osteoarthritis. Alexander 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 treatment to begin sooner.
  • 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 at diagnosing the progression of osteoarthritis in the knee than current methods.

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

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

Their study is 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 identify the right patients for the therapy,” said Virginia Byers Kraus, MD, lead author of the study and professor of medicine, departments of pathology and orthopedics at Duke University School of Medicine, in a statement.

Kraus described the situation as “the chicken and egg dilemma.”

“In the near future, this new test will help identify people at high risk of progressive disease – those likely to have pain and worsening disability identified on X-rays – who should be included in clinical trials,” she added. . “Then we can learn whether a therapy is helpful.”

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

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

The research team said they isolated more than a dozen molecules in the blood linked to disease progression.

The researchers eventually narrowed the blood test 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, told Healthline that she was impressed by the study’s numbers.

“That’s an incredible percentage,” Bard said. “It’s just that investigational treatments for this condition never seem to work. And the way we’ve diagnosed it now, with X-rays, is not very accurate. It doesn’t really correlate with the symptoms.

Bard told Healthline that 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 (nonsteroidal anti-inflammatory drugs), lidocaine, and intra-articular injections like hyaluronic acid, PRP, and steroids,” she added.

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

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

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

“The images today tell us a lot,” Beyer said. “Years of clinical experience with patients in the exam room reveal even more. A blood test to confirm the diagnosis would be nice, but at what cost to the patient?’

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

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

Dr. Joshua Carothers is a Fellow of the American Academy of Orthopedic Surgeons and Chief Medical Officer of VIP StarNetwork Mobile Health Service.

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

“There are modern treatments for osteoarthritis. However, they are primarily aimed at addressing the symptoms such as pain, swelling and disability associated with disease progression,” Carothers said. “Often this ends up with a joint replacement procedure. They are effective for the symptoms, but it would be fair to say that we have no treatment that is effective in stopping or reversing the disease process of osteoarthritis.

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

“There are currently no widely available molecular or blood testing methods that can inform the average clinician or orthopedist about the extent of arthritis or the likelihood of its progression,” Carothers said. “Our testing conditions primarily include a history and physical examination of the patient, radiographic examination, and more advanced imaging such as magnetic resonance imaging. (MRI) are expensive and time consuming and are not an effective way to monitor osteoarthritis.

Carothers said a blood test with 73 percent accuracy could help counter the unpredictability of osteoarthritis.

“Of course, there would be a lot of interest in a blood test that could accurately describe the current state of cartilage and the likelihood that arthritis will progress over a period of time,” he said. “Additionally useful information would be to predict which treatment methods would be most effective in different patients.”

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

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