Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Osteoarthritis Summit delineates shortcomings of research and path forward

09.03.2012
A recent summit that brought together international multidisciplinary experts has provided a foundation for addressing what is the leading cause of disability in the United States: osteoarthritis.

Currently, validated pharmacologic interventions do not exist for effectively eliminating pain and restoring function during progression of osteoarthritis, a disease whose prevalence is expected to dramatically rise within the next decade and inflict a huge economic impact on society.

The summit, which was hosted by Hospital for Special Surgery in New York City, is a first step in building consensus about what needs to be done to advance treatments and design preventive strategies. Consensus statements and analysis from the summit appear as part of a series of papers in Volume 8, Issue 1, of the Hospital for Special Surgery Journal published on March 9.

"The summit included leading scientists and researchers across all of the broad disciplines related to osteoarthritis, ranging from very basic cell and molecular biology, to biomechanics, to epidemiology and clinical trials," said Steven Goldring, M.D., chief scientific officer at Hospital for Special Surgery (HSS) who, along with Timothy Wright, Ph.D., Kirby chair of orthopedic biomechanics at HSS, co-directed the Osteoarthritis Summit: Frontiers in OA research, Prevention, and Care. "This is a clinical disorder in which there are multiple factors that contribute to the initiation, progression and disease outcome, and the only way we are going to be able to define the underlying mechanisms and develop effective therapies is to bring together individuals who are experts in each of these disciplines and create a forum for discussion and exchange of knowledge," said Dr. Goldring.

Although joint replacement surgery is an effective late-stage treatment for osteoarthritis and much has been learned about the disease, little progress has been made in terms of preventing or slowing the progression of osteoarthritis. The summit brought together 35 experts in the field, including research scientists, clinicians, physical therapists, government officials, and members of the pharmaceutical, device and insurance industries. Over the two-day summit, the experts focused on the classification, pathology, diagnosis, assessment, treatment, and preventative and public health strategies for management of osteoarthritis.

"A forum for osteoarthritis that brings together experts from such diverse specialties and interests for discussion and exchange of knowledge doesn't really exist under normal circumstances because these communities tend to publish in their own specialty journal or attend their own specialty meeting," said Dr. Goldring, who is also the Richard L. Menschel Research Chair at HSS. "The summit opened the lines of communication that are needed to advance the understanding of the disease and come up with new treatments and more effective strategies for osteoarthritis prevention and management."

The summary of results in Volume 8, Issue 1, of the HSS Journal highlights a number of steps that need to be taken. For example, the summit concluded that the current classification system for osteoarthritis is inadequate. The experts proposed a classification tree that identifies osteoarthritis as spontaneous or induced, and further classifies the disease based on symptoms, associated bone structural abnormalities, cartilage and related joint tissue abnormalities, and stage of disease progression.

"Osteoarthritis is an extremely heterogeneous disorder in terms of the factors that contribute to the loss of joint function," said Dr. Goldring. "If we are going to design treatments for patients, we need to have a classification system that describes what is really driving the process. As the disease progresses, the mechanisms that contribute to signs, symptoms and destruction of the joint tissues vary in a given patient and throughout the course of the disease. We need to be able to know where a patient is in the progression of the disease to be able to target those specific processes that are responsible for the symptoms and loss of joint function and select the appropriate therapy."

To focus discussion at the summit, participants were challenged to develop answers to critical questions and issues, and these answers are elaborated on in the individual articles in Volume 8, Issue 1, of the HSS Journal. For example, a question regarding the optimal tools for diagnosis and for monitoring progression and response to therapy brought about a consensus about the current state and future of biomarkers for osteoarthritis. There is a great need to educate the government and regulatory agencies about realistic and more meaningful markers that can be used for disease staging and to evaluate therapies. Currently, early research has identified blood or urine markers that can provide researchers with an idea of what is going on inside an affected joint without clinicians having to do an invasive procedure, but further research is needed to validate these markers and find better ones.

Another hot topic was prevention, specifically weight loss in obese patients. Weight reduction is generally ignored among therapeutic interventions when, in fact, it has been shown to be successful in treating pain in obese patients with osteoarthritis. Encouraging insurance companies to pay for supervised exercise and weight loss interventions is one avenue that needs to be explored.

Another consensus reached was that treatment approaches that integrate multidisciplinary health professions are needed, rather than a patient seeking a second and third opinion from multiple physicians. From a public health standpoint, there is a great need to emphasize nonpharmacological therapies, such as exercise, and physicians typically do not have the time to provide adequate lifestyle advice to patients.

"The summit is unique in that we brought together the most expert people in the world across all of the relevant disciplines. We spent the majority of our time engaged in breakout sessions in discussions to address the challenging questions and issues related to osteoarthritis diagnosis, treatment and management. It is probably the most current overview of where the field stands at this point," said Dr. Goldring, referring to the meeting summaries published in the journal.

According to the summit attendees, many pharmaceutical companies have dropped out of the field of osteoarthritis research and drug development because of the complexity of the disease and the regulatory barriers standing in the way of bringing a drug to market. Disseminating information from the summit will hopefully spur research forward and help to break down many of the barriers that have prevented advances in the care and management of patients with osteoarthritis.

The conference featured 35 distinguished speakers from institutions including the National Institutes of Health, the Arthritis Foundation, Hospital for Special Surgery, Rush Medical Center, Brigham and Women's Hospital, Tufts, Wake Forest, Duke University, McGill University in Canada, and the University of Sydney. Funding for the summit was supplied by the National Institutes of Health-funded Weill Clinical Translational Science Center, Amgen, Endo Pharmaceuticals, Genzyme Biosurgery, Novartis Pharmaceuticals, Pfizer and Zimmer.

About Hospital for Special Surgery

Founded in 1863, Hospital for Special Surgery (HSS) is a world leader in orthopedics, rheumatology and rehabilitation. HSS is nationally ranked No. 1 in orthopedics, No. 2 in rheumatology, No. 19 in neurology, and No. 16 in geriatrics by U.S.News & World Report (2011-12), and is the first hospital in New York State to receive Magnet Recognition for Excellence in Nursing Service from the American Nurses Credentialing Center three consecutive times. HSS has one of the lowest infection rates in the country. From 2007 to 2011, HSS has been a recipient of the HealthGrades Joint Replacement Excellence Award. HSS is a member of the NewYork-Presbyterian Healthcare System and an affiliate of Weill Cornell Medical College and as such all Hospital for Special Surgery medical staff are faculty of Weill Cornell. The hospital's research division is internationally recognized as a leader in the investigation of musculoskeletal and autoimmune diseases. Hospital for Special Surgery is located in New York City and online at www.hss.edu.

For more information contact:

Phyllis Fisher
212-606-1197
FisherP@hss.edu
Tracy Hickenbottom
212-606-1197
HickenbottomT@hss.edu

Phyllis Fisher | EurekAlert!
Further information:
http://www.hss.edu

More articles from Health and Medicine:

nachricht Study suggests possible new target for treating and preventing Alzheimer's
02.12.2016 | Oregon Health & Science University

nachricht The first analysis of Ewing's sarcoma methyloma opens doors to new treatments
01.12.2016 | IDIBELL-Bellvitge Biomedical Research Institute

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Novel silicon etching technique crafts 3-D gradient refractive index micro-optics

A multi-institutional research collaboration has created a novel approach for fabricating three-dimensional micro-optics through the shape-defined formation of porous silicon (PSi), with broad impacts in integrated optoelectronics, imaging, and photovoltaics.

Working with colleagues at Stanford and The Dow Chemical Company, researchers at the University of Illinois at Urbana-Champaign fabricated 3-D birefringent...

Im Focus: Quantum Particles Form Droplets

In experiments with magnetic atoms conducted at extremely low temperatures, scientists have demonstrated a unique phase of matter: The atoms form a new type of quantum liquid or quantum droplet state. These so called quantum droplets may preserve their form in absence of external confinement because of quantum effects. The joint team of experimental physicists from Innsbruck and theoretical physicists from Hannover report on their findings in the journal Physical Review X.

“Our Quantum droplets are in the gas phase but they still drop like a rock,” explains experimental physicist Francesca Ferlaino when talking about the...

Im Focus: MADMAX: Max Planck Institute for Physics takes up axion research

The Max Planck Institute for Physics (MPP) is opening up a new research field. A workshop from November 21 - 22, 2016 will mark the start of activities for an innovative axion experiment. Axions are still only purely hypothetical particles. Their detection could solve two fundamental problems in particle physics: What dark matter consists of and why it has not yet been possible to directly observe a CP violation for the strong interaction.

The “MADMAX” project is the MPP’s commitment to axion research. Axions are so far only a theoretical prediction and are difficult to detect: on the one hand,...

Im Focus: Molecules change shape when wet

Broadband rotational spectroscopy unravels structural reshaping of isolated molecules in the gas phase to accommodate water

In two recent publications in the Journal of Chemical Physics and in the Journal of Physical Chemistry Letters, researchers around Melanie Schnell from the Max...

Im Focus: Fraunhofer ISE Develops Highly Compact, High Frequency DC/DC Converter for Aviation

The efficiency of power electronic systems is not solely dependent on electrical efficiency but also on weight, for example, in mobile systems. When the weight of relevant components and devices in airplanes, for instance, is reduced, fuel savings can be achieved and correspondingly greenhouse gas emissions decreased. New materials and components based on gallium nitride (GaN) can help to reduce weight and increase the efficiency. With these new materials, power electronic switches can be operated at higher switching frequency, resulting in higher power density and lower material costs.

Researchers at the Fraunhofer Institute for Solar Energy Systems ISE together with partners have investigated how these materials can be used to make power...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

ICTM Conference 2017: Production technology for turbomachine manufacturing of the future

16.11.2016 | Event News

Innovation Day Laser Technology – Laser Additive Manufacturing

01.11.2016 | Event News

#IC2S2: When Social Science meets Computer Science - GESIS will host the IC2S2 conference 2017

14.10.2016 | Event News

 
Latest News

UTSA study describes new minimally invasive device to treat cancer and other illnesses

02.12.2016 | Medical Engineering

Plasma-zapping process could yield trans fat-free soybean oil product

02.12.2016 | Agricultural and Forestry Science

What do Netflix, Google and planetary systems have in common?

02.12.2016 | Physics and Astronomy

VideoLinks
B2B-VideoLinks
More VideoLinks >>>