Osteoarthritis

Disorders of the musculoskeletal system occur with great frequency and are a major – and mostly unaddressed – cause of disability worldwide. Arthritis is a condition that leads to tenderness and swelling in one or more joints and is often accompanied by severe chronic pain. Osteoarthritis (OA) is the most common form of the disease, often occurring later in life. OA has an exceptionally high global burden which is increasing with aging populations, a rise in obesity and lifestyle changes. The direct economic cost associated with OA is immense in terms of healthcare and surgery costs. In addition, the impact on patients and their families is very high because of disability and loss of income. Despite this prevalence, there is no pharmacological intervention, treatment or procedure that is capable of reversing or delaying the onset of OA – all treatment options are associated with pain relief rather than modifying the course of the disease. In contrast, rheumatoid arthritis, the next most common form of joint disease, can be treated using several successful biologic therapies that have been available for a number of years. The major intervention for OA is joint replacement, a major surgical procedure which involves removal of the damaged joint tissue and replacement with a prosthetic implant. 

The REMEDI Osteoarthritis Research Programme

Our research is  focussed on developing innovative treatments that can be disease-modifying rather than symptom-modifying, thus delaying or avoiding the need for joint replacement surgery. We have developed cell therapy protocols that have been very successful in treating OA in preclinical models and are currently working towards assessing these in patient studies. In this work, adult stromal cells are prepared as an injectable treatment for knee OA. We completed the ADIPOA clinical trial, a phase 1 assessment of autologous cell therapy. In this small study, patients received an injection of cells extracted from their own adipose tissue. The outcome was positive, although the study was not large enough to reach a definitive conclusion. We recently initiated a much larger study which is currently underway and which, when concluded, will help to determine the effectiveness of this approach in a more rigorous way. In addition to clinical assessment, we carry out research to understand the biological mechanisms of repair associated with cell delivery to the OA joint. This leads to new understanding of the cells as a medicinal product and how they function as a treatment for OA. In turn, this will provide opportunities for improving the treatment and will give rise to next-generation therapies. 

Relevant Research Groups