Purpose
To conduct a review of active United States–based clinical trials investigating preventative,
symptom resolution, and disease-modifying therapies for osteoarthritis (OA).
Methods
We conducted a review of currently active clinical trials for OA using data obtained
from the ClinicalTrials.gov database as of August 2020. The inclusion criteria were active studies registered
in the United States that involved the prevention, symptom resolution, or disease
modification of OA. Descriptive statistics were recorded and summarized.
Results
A total of 3,859 clinical trials were identified, and 310 were included in the final
analysis. Of the currently active trials, 89% (n = 275) targeted symptom resolution
in patients with existing OA, 6% (n = 19) targeted OA disease-modifying therapeutics,
and 5% (n = 16) targeted the prevention of OA in high-risk patients (P < .001). Primary interventions included medical devices (44%, n = 137), pharmaceutical
drugs (14%, n = 42), surgical procedures (14%, n = 42), cellular biologics (13%, n =
41), and behavioral therapies (13%, n = 41). There was a significantly higher number
of disease-modifying therapeutics for cellular biologics than pharmaceutical drugs
(30% vs 14%) (P = .015). Most trials targeted the knee joint (63%, P = .042), with 38% of all trials evaluating joint arthroplasty. There were no significant
differences between private sector and government funding sources (43% and 49%, respectively)
(P = .288), yet there was a significantly lower rate of funding from industry (8%) (P = .026).
Conclusions
There was a significantly higher number of clinical trials investigating symptomatic
resolution therapy (89%) for existing OA in comparison to preventative (5%) and disease-modifying
(6%) therapies. The most common interventions involved medical devices and joint replacement
surgery, with the knee joint accounting for more than 60% of the current clinical
trials for OA. There was a significantly higher number of disease-modifying therapeutics
for cellular biologics than pharmaceutical drugs. Funding of clinical trials was split
between the private sector and government, with a low rate of reported funding from
industry partners.
Clinical Relevance
Identifying existing needs in the current market may help increase rates of research
funding or optimize current funding pathways, in this study, specifically for targeting
unaddressed focus areas in OA research. Our systematic review highlights the potential
need for additional research and development regarding OA preventative and disease-modifying
therapies.
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Article info
Publication history
Published online: March 30, 2021
Accepted:
March 23,
2021
Received:
January 8,
2021
See commentary on page 2640Footnotes
The authors report the following potential conflicts of interest or sources of funding: G.M. is a member of the Arthroscopy Editorial Board and committee member of the International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine. J.C. is a consultant for Smith & Nephew, Arthrex, ConMed, and Ossur, outside the submitted work. R.F.L. is a consultant for Smith & Nephew, Arthrex, and Ossur and receives royalties from Smith & Nephew, Arthrex, and Ossur. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
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© 2021 by the Arthroscopy Association of North America
