Arthritis is an umbrella term used to describe painful inflammation of the joints, and covers several different types of rheumatic disorders. Osteoarthritis (OA) is one of the most common forms of arthritis, accounting for 300 million cases of arthritis around the world as of 2017.

Some other common types of arthritis are autoimmune conditions, such as Rheumatoid Arthritis. The kinds of medication used to treat these inflammatory forms of arthritis have progressed rapidly over the last few decades.

Medications such as Biologics and Disease Modifying Anti-Rheumatic Drugs (DMARD’s) work by interfering with the progression of the disease by tackling inflammation and calming an overreactive immune system, which is the hallmark of autoimmune conditions.

Osteoarthritis is very common in older people, and is not an autoimmune disease. OA occurs when the protective cartilage between joints is damaged and worn down over time, and the damage cannot be reversed. It is possible to limit the progression of OA by maintaining an active lifestyle and a healthy weight. Symptoms can usually be managed when treated early on.

Signs and symptoms of OA

The condition is characterised by certain signs and symptoms which tend to develop slowly over a period of time.

• Tenderness – Applying light pressure to your joints may cause them to feel tender
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• Pain – Joints tend to hurt during or after movement
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• Stiffness – You may notice stiffness or pain when you first wake up in the morning, as well as after periods of inactivity
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• Loss of flexibility – You may not be able to move your joint through it’s full range of motion
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• Swelling – This can be caused by tissue inflammation around the joint
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• Grating and popping of joints – Hearing a crackling or feeling your joint pop is quite common
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• Bone Spurs – Hard lumps of bone sometimes form around the affected joint

Risk factors

The risk of Osteoarthritis increases with age, and other factors such as obesity and previous joint injuries can sometimes mean you’re at a higher risk for developing OA. When you carry extra weight, more pressure is exerted on your joints which make the job of supporting your movement harder.

While weight loss doesn’t impact risk factors for the autoimmune types of arthritis, studies have shown that reducing weight is an effective way to manage pain associated with Osteoarthritis. For each half kilo of weight lost, the pressure on the knee is reduced by four times this.

Another risk factor in OA is being female. Researchers aren’t entirely sure why women are at a higher risk of developing Osteoarthritis, but there is some evidence to suggest it may be a combination of factors such as having wider hips, a larger fluctuation in hormones such as Oestrogen and Testosterone, as well as childbirth.

Some studies have shown women to be 2.6 times more likely to develop knee or hip arthritis after carrying 5-12 children to full term.

Current Treatments

OA cannot be reversed, but some medications and physiotherapy can help manage pain and enhance movement.

• NSAID’s – Non Steroidal Anti Inflammatory Drugs are used to treat a variety of illnesses, and they work by reducing inflammation.
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• Heat and cold – specific temperatures can help manage pain. Applying a cool pack after exercise can help to reduce inflammation, whereas moist heat can help relax muscles and ease pain.
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• Cortisone (steroid) injections – Steroids are effective in reducing inflammation of joints, which can help with pain. These kinds of injections are limited to only a few a year, and this is because steroids can actually worsen joint damage if done too frequently.
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• Lubrication injections – Hyaluronic acid may provide some relief by attempting to cushion the joint, but the jury is still out on whether or not these injections are more effective than placebo.
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• Arthroplasty (joint replacement surgery) – is sometimes performed to remove damaged joint surfaces, replacing them with artificial parts. Like many surgeries, an arthroplasty carries a risk of infection and blood clots. Joint replacements are often considered as a last resort, as they only last 10-15 years. Newer joint replacements however may last up to 20 years.

Why do we need clinical trials for Osteoarthritis?

The above treatment options have been around for quite some time, and while they certainly play a part in reduction of pain symptoms and potentially slowing the progression of OA, there are many ways science can improve these treatments and enhance their potential in limiting joint damage.

Clinical trials testing new medications carry large benefits for society, and for those who participate in the study. Study participants are contributing to future medicine and the understanding of a disease which will help many people further down the line.

Participants have early access to this medicine, and therefore an opportunity to potentially minimise or slow the progression of their illness before the drug becomes available to the wider public, so long as the clinical trial progresses to the final phases to receive medication approval.