Blood-Based Test Accurately Predicts Osteoarthritis Progression

DURHAM, NC — A new blood test that identifies the progression of osteoarthritis in the knee is more accurate than current methods, thus, providing an important tool to advance research and discovery of new therapies.

The test relies on a biomarker and fills an important void in medical research for osteoarthritis, which currently lacks effective treatments. With no way to accurately identify and predict the risk of osteoarthritis progression, researchers have been unable to include the right patients in clinical trials to test whether or not a treatment is beneficial.

“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 Virginia Byers Kraus, MD, PhD, professor in the departments of Medicine, Pathology, and Orthopedic Surgery at Duke University School of Medicine, and senior author of a new paper published in Science Advances on January 25.

“It’s a chicken-and-the-egg predicament,” Kraus said. “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. Then we can learn if a therapy is beneficial.”

Kraus and colleagues isolated more than 12 molecules from blood samples associated with the progression of osteoarthritis—the most common joint disorder in the US. It afflicts 10 percent of men and 13 percent of women over the age of 60 and is a major cause of disability.

The researchers narrowed the blood test to a set of 15 markers that correspond to 13 total proteins. These markers accurately predicted 73 percent of progressors from nonprogressors among 596 people with knee osteoarthritis. Assessing baseline structural osteoarthritis and pain severity is 59 percent accurate, while the current biomarker testing molecules from urine is 58 percent accurate. The prediction rate using these new blood biomarkers is more accurate than that of existing approaches.

The new, blood-based marker set also successfully identified the group of patients whose joints show progression in X-ray scans, regardless of pain symptoms.

“In addition to being more accurate, this new biomarker has an additional advantage of being a blood-based test,” Kraus said. “Blood is a readily accessible biospecimen, making it an important way to identify people for clinical trial enrollment and those most in need of treatment.”

Along with Kraus, authors of “A “best-in-class” systemic biomarker predictor of clinically relevant knee osteoarthritis structural and pain progression” include Kaile Zhou, Yi-Ju Li, Erik J. Soderblom, Alexander Reed, Vaibhav Jain, Shuming Sun, and M. Arthur Moseley.

The study received funding support from the National Institutes of Health (R01AR071450, R01AR048769, P30 AG028716, N01 AR-2-2258, N01-AR-2-2259, N01-AR-2-2260, N01-AR-2-2261, N01-AR-2-2262).

- This press release was originally published on the Duke Health website