Osteoarthritis: Is a Cure on the Launch Pad?

Steve O'Keefe, founder, Angry@Arthritis

I received an osteoarthritis (OA) diagnosis two years ago. As a very active person in my early 50s, how could this happen to me? I eat well and maintain a healthy body weight. Then I learned there is no cure or even viable treatment for this disease that cripples more than 32 million Americans. The attitude of the healthcare industry is best characterized as benign neglect: take a seat and wait out the rest of your life in pain without doing the things that you love. If you have OA in more than one joint, you have to make multiple appointments with doctors because orthopedists will only address one joint at a time.

The most common advice from the medical community is to have a joint replacement. In fact, according to the CDC and the American College of Rheumatology, Americans get 790,000 knees and 470,000 hips each year.¹ Those numbers are skyrocketing as America gets older and heavier—while millions of other people limp along trying to avoid prosthetic joints.

Joint replacement is not a good option. First, they only treat OA in the knees and hips. There are very few joint replacement options for elbows and shoulders, and there is absolutely nothing available for hands, feet, and ankles. Second, joint replacements are not a good solution for active people under 60 years of age. This is because artificial joints do not tolerate impact from running and jumping, and they wear out in 10–20 years.

One of the major problems with the science around treating OA is that it is not lethal. If it were more fatal, medical science would have looked harder for a cure. Ironically, OA is actually very deadly. Folks with OA stop moving, which drives weight gain and follow-on deadly diseases like heart disease and diabetes.

What can patients do today, rather than get flawed synthetic joints and sit down to wait out their lives gaining weight? We need to get smarter about emerging treatments and get involved in the OA cure movement.

The science that could lead to a cure

The science around a cure is changing fast, and we have a host of viable cures on the horizon. I see hope because in May, the US government, in the form of The Advanced Research Project Agency for Health (ARPA-H), announced an OA cure moonshot, Novel Innovations for Tissue Regeneration in Osteoarthritis.

ARPA-H is talking about delivering new cures to people in five years. The NITRO program challenges and funds OA research and clinical innovators from all over the world to bring together their best treatments to cure OA. Through my own extensive global search for OA innovators, I have identified the following group I call “The OA Cure Magnificent Seven,” the leading guns in the battle for an OA cure:

Ivan Martin, PhD, chair of the department of biomedicine at the University of Basel, Switzerland. The team’s Nasal Tissue Engineered Cartilage (N-TEC) treatment harvests cells from nasal cartilage and grows them into cartilage patches, which are surgically inserted into cartilage defects and damaged OA joints. Martin’s team has treated more than 100 human patients’ knees, shoulders, and ankles with N-TEC.

Jennifer Elisseeff, PhD, director of the Translational Tissue Engineering Center at Johns Hopkins University. Elisseeff is leading the charge on regenerative immunology and senolytics—treatments that promise to empower patients’ bodies to repair their joints themselves.

Brad Estes, PhD, CEO and founder, CytexOrtho, in North Carolina. Estes has created cutting-edge regenerative medical implants that mimic natural tissue to repair damaged joints. CytexOrtho is entering human clinical trials in the hip later this year.

Yusuf Yazici, MD, chief medical officer at Biosplice Therapeutics, in San Diego, California. Biosplice is currently in Phase III clinical trials with its drug Lorecivivint, an injectable CLK/DYRK inhibitor thought to modulate Wnt and inflammatory pathways.

Charles KF Chan, MD, assistant professor of surgery (Plastic & Reconstructive Surgery), Stanford University, California. Chan is pioneering Microfracture 2.0—a new twist on a long-established procedure to stimulate new cartilage growth. Microfracture is powered by drilling into the bone to create new cartilage. But, historically, that cartilage has been inferior, fibrous cartilage. Microfracture 2.0 manipulates the newly formed joint material away from fibrocartilage into new articular cartilage and is about to enter clinical trials.

• Ben Wiley, PhD, chief technical officer, Sparta Biomedical, Durham, North Carolina. Wiley is taking a completely different approach. Instead of regrowing natural cartilage, he’s manufacturing synthetic cartilage. On the verge of human clinical trials, Sparta’s Galene bionic joint platform is flexing from a fix to focal cartilage defects to a new approach to synthetic joint replacement.
• Celeste Scotti, MD, PhD, global program clinical head, Novartis. LNA 043, which is a drug that grows cartilage in the knee, is the big hope for an injectable cure for OA. Novartis is currently FDA fast-tracking Phase II clinical trials in humans.

With NITRO underway and the OA Cure Magnificent Seven riding hard, the time is coming when we can develop a cure for all those afflicted with OA. To paraphrase Estes at CytexOrtho: “Why replace your joints when you can renew them?”

Steve O’Keeffe is the founder of Angry@Arthritis, a non-profit focused on curing osteoarthritis.

Reference

American College of Rheumatology, “Joint Replacement Surgery, Fast Facts,” accessed July 2023. https://rheumatology.org/patients/joint-replacement-surgery