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Could osteoarthritis be treated as two separate diseases?

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Treatment for osteoarthritis could be more effective if patients are divided into different disease groups, according to new research.

Scientists at the University of Manchester have found that that the current definition of osteoarthritis may actually encompass two distinct subgroups with different patterns of disease activity.

This suggests that developing new treatments for both versions may be more effective than the current ‘one-size-fits-all’ approach.

The research, funded by Arthritis Research UK, involved a mathematical analysis of the thousands of genes expressed in the cartilage of 60 individual patients with knee osteoarthritis. Samples were separated into categories based on the level of active metabolism in the diseased tissue, resulting in two groups of patients.

Genetic differences were found between these two groups, and the researchers developed a list of biomarkers that could be used to help distinguish between them by analysing the synovial fluid, which is found in the cavities of joints.

The researchers believe that the variations between the two patient categories could be used to predict different responses to treatment.

Professor Tim Hardingham, based at the University’s Wellcome Trust Centre for Cell-Matrix Research and Division of Cell Matrix Biology and Regenerative Medicine, pointed out that there has been little advance in the treatments for osteoarthritis for 30 years.

“There is an urgent need for better treatments and we hope this research may help us along that road,” he said.

The findings have been published in the journal Annals of the Rheumatic Diseases.