Duke Awarded Federal Funding up to $33 Million to Develop Osteoarthritis Therapies

The federal Advanced Research Projects Agency for Health (ARPA-H) has awarded up to $33 million to a team, including Duke Health, to fund research into osteoarthritis (OA) therapies that rebuild bone and joints. Benjamin A. Alman, MD, chair of the Duke Department of Orthopaedic Surgery, is directing the project in collaboration with Boston Children’s Hospital and the David Geffen School of Medicine at UCLA.

“As a leading cause of disability, osteoarthritis affects about 30 million people in the U.S. and represents a $128 billion cost burden on the health care system,” says Alman. “We need a new approach to treatments. Regenerating cartilage and bone would be an effective therapy, and we have the technology, resources, and expertise to make this a reality.”

Study design and goals

The project will simultaneously use multiple arms to optimize and deliver a potential new therapy to patients quickly. It will build on previous findings from project members, including identifying small molecules and proteins that improve the cartilage regeneration process, developing methods to deliver agents and target them to relevant joint tissues, restoring joint and bone tissue to a “younger” state in animal studies, and understanding the genes and pathways needed to generate articular cartilage.

“Duke is well suited to coordinate this project because we provide clinical care at the highest level while also performing top-level research,” says Alman. “We already have several programs to provide cutting-edge care for all stages of osteoarthritis to delay the need for arthroplasties, provide nonoperative management for symptoms and pain relief, determine which types of surgeries best match each patient, and shorten hospital stays.”

The researchers propose three therapies:

• an injection into the joint to release regenerative factors in the bone supporting injured cartilage
• an injection into the joint to regenerate cartilage tissue
• an IV version of the injectable that could home in on diseased cartilage tissues in patients who have osteoarthritis in multiple joints

The project also seeks to recruit a study population representative of patients in the U.S. with osteoarthritis. “Osteoarthritis does not affect all populations equally, and the project will include an arm to identify populations that would benefit the most and to ensure that the proposed therapies are readily available to those patients,” says Alman.

ARPA-H is a federal agency established to advance high-potential, high-impact biomedical and health research that cannot be readily accomplished through traditional research or commercial activity. Designed to develop innovative ways for joints to heal themselves, ARPA-H’s Novel Innovations for Tissue Regeneration in Osteoarthritis (NITRO) program provides the funding for this project.