Cookies on this website

We use cookies to ensure that we give you the best experience on our website. If you click 'Accept all cookies' we'll assume that you are happy to receive all cookies and you won't see this message again. If you click 'Reject all non-essential cookies' only necessary cookies providing core functionality such as security, network management, and accessibility will be enabled. Click 'Find out more' for information on how to change your cookie settings.

Researchers at NDORMS have identified four subgroups of knee osteoarthritis which will improve patient treatment and drug development.

The study, led by Dr Maja Radojčić, Postdoctoral Researcher at NDORMS examined pain trajectories of patients with knee osteoarthritis (OA), a chronic joint disease that limits function and affects quality of life. Knee OA has generally been thought of as a heterogeneous disease with treatment options focusing on pain management or the surgical option of joint replacement.

However, by measuring patients’ pain experience, functional limitation, and responsiveness to available treatment options over time, the team were able to categorise patients into four different phenotypes: low-fluctuating, mild-increasing, moderate-treatment-sensitive and severe-treatment-insensitive pain. Importantly, the group in need of novel options not responsive to current treatments was found, as well as a subgroup that significantly improved after surgery.

Maja said: “Our results will help inform clinicians about symptom development and open the way to focus on more targeted personalised treatments for OA patients.”

“It has previously been thought that some patients might have good joint functionality despite severe pain,” she continued. “But we mapped dual trajectories to investigate the interplay between pain and functional limitation over time and showed that they go hand-by-hand, developing the same pattern or patients not distinguishing them.”

The significance of findings for the clinical trial design stressed co-author Professor Nigel Arden. “Selecting patients who are most in need and likely to benefit from a specific treatment option, as well as not selecting those unlikely to progress over years or responding to placebo will help OA clinical trials to reach endpoints.”

The personalised medicine in OA has been identified as a need by the research community, but except theoretical concept underpinned by assumptions about different processes involved, there has not been a phenotyping work to support it. The senior author Dr Stefan Kluzek said: “Our research showed for the first time presence of clinical phenotypes of knee OA, which are reproducible between studies and share some common characteristics.” He continued: “Different responsiveness of each group to current treatments is of paramount importance to our understanding of the most effective clinical pathways but also suggests diverse molecular mechanisms underlying osteoarthritis.”

The research was funded by Versus Arthritis, as a work package of the Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, and supported by the OAI study.

Similar stories

£1.2M to improve diagnosis of emergency spinal condition

The National Institute for Health and Care Research has awarded an Advanced Fellowship to Dr David Metcalfe to study the diagnosis of the spinal condition, cauda equina syndrome.

Professor Chris Lavy appointed to WHO technical advisory group

Congratulations to Professor Chris Lavy, who has been appointed to the World Health Organization’s (WHO) technical advisory group for integrated clinical care for a period of two years.

Oxford receives NIHR funding to test anti-TNF on post operative delirium

Researchers at the University of Oxford have been awarded a grant from the National Institute for Health and Care Research (NIHR) to investigate whether anti-tumour necrosis factor (TNF) therapy can reduce or prevent post operative delirium/cognitive deficit.

Gene variant links trigger finger and carpal tunnel syndrome

A new NDORMS study, published in The Lancet Rheumatology, has found a genetic variant that increases the risk of both carpal tunnel syndrome and trigger finger, and opens the door for new therapies that involve blocking the IGF-1 pathway.

Kennedy programmes support early career researchers

Since 2013 the Kennedy Institute of Rheumatology has been running a Career Development Programme, a scheme to help early career researchers launch their own independent laboratories, and more recently the Innovator Investigator Programme to bring new technologies to core research themes.

OCTRU collaboration boosts understanding of COVID vaccine response

Working with researchers across multiple universities, the Oxford Clinical Trials Unit (OCTRU) played a key role in delivering results of the national VROOM trial (Vaccine Response On Off Methotrexate).