Tag Archives: arthritis cure research

dr christian lattermann

Researchers on the Path to a Cure – Spotlight on Dr. Christian Lattermann

Osteoarthritis Center of Excellence Research Story

Over the last month, we’ve kept you updated on the work being done by the researchers in our osteoarthritis (OA) center of excellence (OA COE). The COE is currently funding three Clinical Trial Network demonstration studies that may lead to better diagnosis and earlier treatments for arthritis. Researchers from six different institutions will collaborate in various aspects of these cutting-edge studies. This is the last in a series of three blogs describing these studies.

Most people with partial or complete rupture of the anterior cruciate ligament (ACL) develop post traumatic OA (PTOA) within 10 to 20 years after their injury. Unfortunately, current ACL injury treatment options (both surgical and non-surgical) are successful in the short-term but do little or nothing to reduce the risk of developing PTOA later.

All three of the current OA COE are demonstration projects that build on knowledge gained from earlier foundation-funded ACL and PTOA research.

  • Xiaojuan Li and her team of investigators are working to refine and standardize biomarker assessment in cartilage images obtained through magnetic resonance imaging (MRI) to allow earlier diagnosis.
  • Virginia Byers Kraus and her team are working to identify which biomarkers are most critical for predicting risk of OA after injury and to confirm the earliest and best timepoints to start treatments.
  • Christian Lattermann and his research team are working on establishing a clinical trials platform to put it all together in a demonstration project allowing for the exploration of new therapeutic strategies to prevent PTOA. This platform is designed to incorporate and further validate findings with regards to early biochemical biomarkers and (MRI) imaging biomarkers and patient reported outcomes (PROs) for pain and function.

Dr. Lattermann and his team are basing their OA COE project on what they learned from an earlier Arthritis Foundation-funded study. In 2012, Dr. Lattermann received an Innovative Research Grant for his 2-year project, “IL-1RA Treatment in Patients with Acute ACL Tear and Painful Effusions,” which he worked on with Dr. Kraus. Due to unforeseen difficulties, this study was modified to use a corticosteroid (an anti-inflammatory agent) instead of a blocker of IL-1. The study was the first of its kind to evaluate the effect of an early anti-inflammatory intervention and biomarker profiles in the first couple of weeks after ACL injury. In brief, this study concluded that PTOA begins at the time of ACL injury. In this early study, 49 young adult patients were treated with corticosteroid or placebo at 4 days and 2 weeks following the ACL injury. The study showed that while early treatment with corticosteroid did reduce collagen breakdown in cartilage, it didn’t reduce the anti-inflammatory biomarkers (Interleukin-1 or IL-1) in patients.

Following the previous study, the team continued to work on the FDA approval to use an iL-1 blocker that we believe to be even more effective in blocking inflammation than cortisone. The current OA COE study is now looking at how this injectable drug (also known as IL‑1 receptor antagonist or IL-1Ra) may reduce the risk of developing PTOA in adolescents and young adults (aged 14 to 33) with ACL tears. The goal is that the drug will reduce the level of IL-1 in patients, thereby reducing the future risk of developing PTOA. IL-1Ra is currently used to treat rheumatoid arthritis, juvenile inflammatory arthritis, and post-surgical knee swelling. Dr. Lattermann and his team have received permission by the FDA to treat and study patients after ACL injury using IL-Ra.

Patients who take part in this study will be placed by random into one of three treatment groups:

  • Group 1 will receive a placebo injection at Visit 1(about 4 days after injury) and an IL-1Ra injection at Visit 2 (about 2 weeks after injury).
  • Group 2 will receive an IL-1Ra injection at Visit 1and a placebo injection at Visit 2.
  • Group 3 will receive placebo injections at Visits 1 and 2.

Dr. Lattermann and his team will look at the changes in biomarkers in synovial fluid, blood, and urine at different times beginning within 7 days of the injury for up to 1 year. Knee imaging in the form of MRI scans and x-rays will also be performed for up to 2 years to look for changes.

By looking at biomarkers and knee imaging, researchers hope to pinpoint not only if the drug treatment may be effective, but also the best time to begin treatment to prevent further damage. About 60 patients are planned to be enrolled in this study, with the first patient starting in April.

Dr. Lattermann, the principal investigator, will coordinate the analyses with researchers at the University of California San Francisco and Duke University. Dr. Lattermann is currently a Professor for Orthopaedics and Sports Medicine at the UK College of Medicine (Department of Orthopaedic Surgery and Sports Medicine).

dr virginia byers kraus osteoarthritis research

Researchers on the Path to a Cure – Spotlight on Dr. Virginia Byers Kraus

Osteoarthritis Center of Excellence Research Story

Our osteoarthritis (OA) center of excellence (COE) is currently funding three Clinical Trial Network demonstration studies that may lead to better diagnosis and earlier treatments for OA. Researchers from six different institutions will collaborate in various aspects of these cutting-edge studies. The three studies are connected to one another for a common purpose and they build on previous research funded by the Arthritis Foundation. This is the second in a series of three blogs describing these studies. Read the first one here.

Dr. Virginia Byers Kraus is working to identify biochemical biomarkers found in synovial (joint) fluid and urine from post-traumatic OA patients who have suffered anterior cruciate ligament (ACL) rupture. The samples used for this study come from samples collected from a 2013 Arthritis Foundation-funded project that validated using magnetic resonance imaging (MRI) techniques to measure the molecular changes that begin to occur in joints immediately after an ACL tear.

Urine and synovial fluid (from damaged knee joints) were collected from patients at five timepoints: baseline (less than 4 weeks after the joint injury), during surgery (about 6 weeks after the injury), 6 weeks after surgery, 6 months after surgery, and 1 year after surgery. The analysis of the 177 urine samples and 101 synovial fluid samples will take about 6 months.

The goal of this project is to evaluate which biochemical markers are connected to inflammation and cartilage breakdown following ACL rupture. The team is working to identify which biomarkers are most critical for predicting risk of OA after injury and to confirm the earliest and best timepoints to start treatments.

“With heart attacks, we treat immediately for best results,” explained Dr. Kraus. “We’re hoping to show that the same is true for joint injuries. What is important is the time from the injury to medical intervention. We must treat early to prevent further damage. What we currently see is that about half of the patients who have surgery for an ACL tear eventually develop more serious disease.”

By identifying biomarkers that appear early following an injury and by using more sensitive MRI imaging techniques, researchers hope to identify the individuals at highest risk for more serious joint disease and to determine the “window of opportunity” for providing treatment to prevent subsequent OA. Earlier interventions might include new drugs designed to halt the disease process and other anti-inflammatory drugs, thus reducing the need for joint replacements later and improving the quality of life.

Dr. Kraus was inspired to study OA by her father. Her father, a surgeon during the Vietnam War, damaged his hip and as a result endured 3 hip replacements over the rest of his life. While her father continued working into his 70’s, Dr. Kraus felt frustrated watching his daily suffering and the suffering of her clinic patients. It’s pushed her to want to make a difference and stop OA in its tracks.

“Osteoarthritis is a big and challenging beast -it’s the most prevalent disease in the world,” she explained. “It affects mobility, which in turn affects your heart and many other aspects of your health. We’ve begun to see success in understanding many types of arthritis, but up to now, we haven’t been as successful with OA. It’s so frustrating for me to see the suffering caused by this disease.”

We’re so proud to call Dr. Kraus a Champion of Yes.  She explained why she likes to submit her research projects to us: “The Arthritis Foundation has stayed the course in maintaining prolonged interest in finding a cure. It has worked at building on prior innovative research – it’s hard to get funding for these types of studies. The Foundation has created a nimble mechanism for doing this type of research and moving it forward faster. This brings us closer to finding cures for patients more quickly.”

Dr. Kraus, the principal investigator in this project, is a professor of Medicine, Pathology and Orthopaedic Surgery at Duke University in Durham, NC. She will be working with other researchers from Duke University, as well as researchers from the University of California San Francisco (UCSF), Hospital for Special Surgery (HSS) in NYC, and the Mayo Clinic in Rochester, MN.

Related Resources:

Researchers on the Path to a Cure – Spotlight on Salah Ahmed

If you suffer from rheumatoid arthritis (RA), Dr. Salah Ahmed’s research project may be just your cup of (green) tea! Dr. Ahmed’s 2014 Innovative Research Grant project, “Mechanism of Mcl-1 regulation in RA by EGCG”, looked at the effects of an anti-inflammatory molecule found in green tea (epigallocatechin-3-gallate or EGCG) on a protein (Mcl-1) found in RA joints.

Continue reading Researchers on the Path to a Cure – Spotlight on Salah Ahmed

Arthritis Research Clinical Trials

Arthritis Foundation Awards Funding to Researchers on the Path to a Cure

Committed to accelerating the search for new solutions to arthritis, the Arthritis Foundation has awarded nearly $5.5 million in scientific research funding to 11 individuals we’re confident can help get us there. Our 2015 request for “Delivering on Discovery” proposals resulted in 167 submissions from across the United States and Canada. A panel of advisors selected the proposals they felt showed the greatest promise of achieving a faster cure for one or more types of arthritis.

The winning proposals, which range in amounts from $216,000 to $1.35 million, cover a diversity of topics and include osteoarthritis, rheumatoid arthritis, juvenile arthritis and lupus. What makes this solicitation process particularly unique is that we opened it up to virtually anyone who can provide bold, new ideas that will potentially speed up the discovery of a cure, whether or not the applicant has prior experience in arthritis research. We want to engage the most creative minds in our quest for solutions to arthritis.

Submissions also needed to demonstrate a clear interdisciplinary pathway to viability in the marketplace, as well as be something people with arthritis want and that they believe is important.
Continue reading Arthritis Foundation Awards Funding to Researchers on the Path to a Cure