Research finds drug can limit the effects of hand arthritis

[ NEW RESEARCH HAS FOUND that retinoic acid could play a key anti-inflammatory role in hand osteoarthritis. Around 8.5 million people in the UK live with osteoarthritis – a condition that causes pain and stiffness in joints, as well as fatigue. It can affect any joint in the body, but it’s common for the joints in hands to be affected.

According to arthritis charity versusarthritis it’s easy to underestimate just how often we use our hands. But when they are painful, stiff, or have poor grip strength due to osteoarthritis, everyday tasks – such as opening a jar, holding a pen or doing up buttons – can become incredibly challenging.

Although there are ways to manage the symptoms of osteoarthritis, there are still no disease-modifying drugs that treat the condition. Disease-modifying drugs are drugs that change the way a condition progresses.

The latest study looked at the importance of a molecule called all-trans retinoic acid (at-RA), which is made from vitamin A. It confirmed previous research, which found that that people who have severe hand osteoarthritis are more likely to have genetic changes which affect how the body controls levels of all-trans retinoic acid.

When examining the cartilage from individuals with hand osteoarthritis researchers found that the genetic change led to low levels of at-RA, which was linked to increased inflammation in the cartilage. Inflammation in the cartilage leads to the loss of its smooth surface, thus removing its ability to protect the joint during activity.

They discovered that boosting the levels of all-trans retinoic acid was anti-inflammatory in the cartilage.

When a drug which keeps levels of at-RA higher was given to experimental models of osteoarthritis, the development of the condition was slowed down.

The research is still in its early stages, but it is promising because it gives us a deeper understanding of the causes of hand osteoarthritis and the drugs tested have been used for other conditions with a good safety record.

A small proof-of-concept study is now underway, where the team will test whether the drug reduces cartilage inflammation in patients who are awaiting routine NHS surgery for hand osteoarthritis. If successful, a clinical trial could follow. q