OA biomarkers showing promise but remain a research tool for now

Biomarkers continue to show promise in their potential to predict longer term clinical outcomes-both pain and structural progression in osteoarthritis, but they are still a way off surpassing MRI in effectiveness, says a leading rheumatologist.

Professor David Hunter, Florance and Cope Chair of Rheumatology and Professor of Medicine at University of Sydney and the Royal North Shore Hospital and Consultant Rheumatologist at North Sydney Orthopaedic and Sports Medicine Centre, said new research had identified biomarkers that could be effective predictors of pain and structural worsening of OA.

This research examined the predictive validity of biochemical biomarkers in knee osteoarthritis using data from the FNIH OA Biomarkers Consortium, of which Professor Hunter is a prinicipal investigator.

The findings have been published in the Annals of the Rheumatic Diseases journal, with the authors concluding that “several systemic candidate biomarkers hold promise as predictors of pain and structural worsening of OA.”

“The predictive validity paper examines a diverse, commercially available panel of biochemical markers for their ability to predict longer term clinical outcomes-both pain and structural progression,” Professor Hunter told the limbic.

“The same study has established that a couple of MRI markers appear to perform well in determining those at greatest risk of progression. We will now be pursuing qualification of these markers through regulatory agencies to facilitate more efficient disease modifying clinical trials in osteoarthritis.”

Another paper published in the Annals of the Rheumatic Diseases journal and co-authored by Professor Hunter has laid the foundations for future studies.

“The reference interval paper provides normative data to allow future studies to compare biomarker values against a relatively normal population,” he said.

Authors of this paper said that to our knowledge, this represents the best and most stringent control group ever assayed for OA-related biomarkers.

“These well-phenotyped controls, representing a similar age demographic to that of the OA Initiative-FNIH main study sample, provide a context for interpretation of OA subject biomarker data,” they concluded. “The freely available data set also provides a reference for future human studies.”

Professor Hunter said that while progress was being made, clinicians should not expect biomarkers to be a treatment tool.

“At this point in time biochemical markers remain a research tool,” he said. “For clinicians until their predictive validity improves, it is unlikely that they will be able to inform individual clinical decision-making.”

He said it was difficult to predict whether biomarkers would eventually be more useful than MRI or other diagnostic tools.

“Biochemical markers have inherent appeal for their simplicity,” he said. “At this point in time however, the markers that are commercially available do not appear to perform as well as existing MRI markers.”


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