Could statins help people with osteoarthritis?
This research was completed on 31 March 2010
Published on 31 January 2007
Eighty percent of people over 75 in the UK have osteoarthritis.1 They suffer pain, stiffness and deformity in joints, such as in the knees, hips and hands, which can be severely disabling. Treatment can relieve symptoms, but there is no cure. Researchers are investigating whether statins could offer new hope to people with osteoarthritis.
What's the problem and who does it affect?
Pain, stiffness and deformity
Osteoarthritis is the most common form of arthritis. It occurs frequently in older people, though it can develop at any age. It affects the joints, typically in the hands, knees, hips, feet and spine, causing pain, stiffness, restricted movement and deformity. Symptoms can vary from person to person, often developing slowly over time. For those who are most severely affected, the condition can be extremely disabling. Arthritis in the hips, knees and feet can make it difficult to get out and about. Even within the home, things like climbing the stairs and getting into the bath can become problematic. Arthritis in the hands affects the grip, making it difficult to do everyday things like getting dressed, opening jars, writing, and turning taps or keys. There is no cure for osteoarthritis, and no treatment that can completely prevent the damage to joints. Several things can help relieve the symptoms, including painkillers, anti-inflammatory drugs, exercise and joint replacement operations. Nevertheless, some people find they must learn how to cope with persistent pain and stiffness, which poses a real challenge, especially if they have difficulties sleeping and are worried about losing their independence.
What is the project trying to achieve?
Investigating the potential of treatment with statins
Osteoarthritis results from damage to cartilage. Healthy cartilage protects the ends of bones, absorbing the stresses put on the joint during movement. In osteoarthritis, cartilage becomes pitted, brittle and thin and can completely disappear leaving the bone exposed. The project team believes that harmful enzymes cause this damage by chopping up cartilage. They aim to find ways to stop the production of these enzymes or block their action. They have already made an exciting discovery, during pilot studies in the laboratory, that drugs called statins can block damage to cartilage. In this project, researchers are finding out which two statins show most promise, and performing laboratory investigations into how the drugs seem to work in human joint tissue, focusing on how they affect both the production of harmful enzymes and the signalling pathways between cells. Researchers are also studying whether people who are already taking statins, for example to reduce their cholesterol levels, experience benefits in their joints, by studying cartilage removed during hip replacement operations.
What are the researchers' credentials?
|Project Leader||Professor T E Cawston PhD|
|Location||Collagen Turnover Research Group, Medical School, University of Newcatle upon Tyne|
|Grant awarded||31 October 2006|
|Start date||1 April 2007|
|End date||31 March 2010|
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Professor Cawston is a leading expert in the mechanisms of cartilage loss in arthritis and has worked and published in this area extensively for over 20 years. Initially working at the Strangeways Research Laboratory and then at Addenbrookes Hospital in Cambridge, he moved to Newcastle in 1996 where he established the Musculoskeletal Research Group at Newcastle University. Dr David Young is a molecular biologist who trained at the Universities of Manchester and East Anglia and was recruited as a non clinical lecturer to Newcastle in 2003. Dr Wang Hui has worked as a postdoctoral researcher in cartilage biology at the University of Melbourne and moved to Newcastle in 1999.
Who stands to benefit from this research and how?
The need to prevent disease progression
Researchers hope to discover how statins work – how they prevent damage to cartilage – and determine whether they could be of benefit to people who have osteoarthritis. In theory, all people with osteoarthritis stand to benefit in the future. Current treatments for osteoarthritis can relieve symptoms. But many people live with constant pain, stiffness and reduced mobility in their joints that can be severely disabling. Operations to replace the joints in the knee, or hip, are relatively commonplace. But these are major operations, which carry associated risks. It would be far better to find new treatments that can block the breakdown of cartilage, so slowing the progression of osteoarthritis, preventing damage to joints and reducing the need for knee- or hip-replacement operations. Researchers aim to find out whether statins have the potential to do this. If the results are promising, then the next step would be to work towards clinical trials. This could well happen with minimal delay, as statins are already widely used to reduce cholesterol levels, and they have good safety profiles. Researchers hope that a better understanding of the mechanisms by which statins might prevent damage to cartilage may also enable them to develop other new treatments for osteoarthritis.
1. Osteoarthritis : Epidemiology, Arden N and Nevitt MC; Best Practice and Research; 20 (1) 3-25; 2006