Is There a Cure for Arthritis?

By Linda Rath | Sept. 23, 2022

Billions of dollars spent in arthritis research annually in the U.S. — an estimated $9 billion on rheumatoid arthritis (RA) alone — have led to many new treatments and significant advances in the last 30 years. There still is no cure, but the Arthritis Foundation is committed to advancing research to discover more and better treatments — and cures for the many forms of arthritis and related conditions.

100 Types of Arthritis

There are more than 100 types of arthritis and related conditions, and each looks and behaves differently from the others because they vary genetically and on the cellular level. Arthritis also involves complex interactions among a person’s genes, lifestyle and environment. For example, smokers are more likely to develop arthritis and have worse symptoms than nonsmokers. And early childhood trauma has been linked to inflammatory rheumatic diseases in adults. While treatments for some forms of arthritis overlap, each may require a different approach when it comes to a cure.

Research Goes On

Researchers continue to learn more about the various forms of arthritis and the many ways they can develop. Eventually, a cure for specific types of the disease may be found. In the meantime, they hope to find better treatments, and clinical trials are key to finding safe and effective treatments. Here are some examples:

Axial spondyloarthritis (axSpA) is a type of inflammatory arthritis that mainly attacks the spine and the joints that connect the spine and pelvis (sacroiliac joints). The disease is painful and in the worst cases can cause bones in the spine and in the rib cage to fuse. Yet only about half of patients respond to treatment. In 2021, Canadian researchers reported that an inflammatory protein called macrophage migration inhibitory factor (MIF) plays a role in axSpA. They found much higher concentrations of MIF in the blood and joints of axSpA patients than in people who were healthy or who had other types of arthritis. They also showed that a molecule called MIF098 prevented axSpA from developing or progressing in mice. They plan to test MIF098 in human clinical trials in the future.

The vagus nerve runs from the brain stem down through the neck and into the chest and abdomen. Among other things, it regulates your heart rate, blood pressure and the movement of food through your intestinal tract. In the U.S., a surgically implanted device that electrically stimulates the vagus nerve is approved to treat epilepsy and depression. Noninvasive external stimulators are approved in Europe. A small pilot study in Denmark found that external stimulation of the vagus nerve reduces disease activity and inflammation in people with active RA, though not for those with low disease activity. Up next: larger, placebo-controlled trials, in which the real device is tested against a stand-in that doesn’t work in the same way.

Researchers in Taiwan discovered a molecule that in structure closely resembles quercetin, a potent anti-inflammatory found in many fruits and vegetables. Quercetin lowers blood sugar, blood pressure and LDL cholesterol and may help protect against cancer, heart disease, neurodegenerative diseases and gout. Researchers say the new compound — dubbed Cf-02 — is 50 times stronger than quercetin and may be a potential treatment for osteoarthritis (OA). So far, Cf-02 has been studied in animals and in cartilage removed from patients with OA who underwent knee surgery. Future research will test it in living humans.

The Need for Clinical Trials

Researchers worldwide are looking for better therapies and predictive biomarkers for arthritis. A lot of investigative research goes nowhere. Studies that show safety and potential in animals may move on to clinical trials. These trials test new drugs and devices for safety and effectiveness in people. They’re also used to compare experimental treatments with current ones, learn how health problems like arthritis can be prevented and how to care for people with incurable diseases.

Four Phases
Human clinical trials usually have four phases:

• Phase I trials test a drug’s safety and dosing in a few healthy people. These studies are the most risky because the potential harms aren’t known and except in vaccine trials, participants don’t benefit.  Side effects like nausea and diarrhea are common, but serious side effects are rare in well-run Phase I trials.
• Phase II trials look at an investigative treatment’s effectiveness in people who might benefit from it.
• Phase III trials test for safety and effectiveness in thousands of people, focusing on different dosages, populations and drug interactions. If the results are positive, the Food and Drug Administration (FDA) may approve the drug or device for clinical use.
• Phase IV or post-marketing studies follow people using a drug or device after FDA approval. Such studies are critically important because problems may not show up until hundreds of thousands of people have used a product in the real world over time.

Why Join a Clinical Trial?
If you’re considering joining a trial to help find more effective treatments for arthritis or because available treatments haven’t helped you, start by talking to your rheumatologist. You can also check clinicaltrials.gov, a database of more than 400,000 research trials in the U.S. and 221 other countries. Before joining any trial, it’s important to fully understand:

The potential risks

• How the Office of Human Research Protections (OHRP) and data safety monitoring boards (DSMBs) try to mitigate risks
• Factors that may exclude you from participating, such as your age, medications, other health problems or location
• The odds you may get a placebo instead of the experimental treatment
• What happens when the trial ends — do you learn the results or get other information that may be useful?

How the Arthritis Foundation Is Helping

The Arthritis Foundation is dedicated to scientific research. We not only provide financial support but we also are actively involved in programs that support the arthritis community. We are launching our first Foundation-directed clinical trial for OA prevention. And we have expanded our fellowship program to train more adult and pediatric rheumatologists to help fill the shortage, helping to increase access to health care professionals and resources to neglected minority communities and supported pilot programs in telehealth and care for the uninsured and underinsured.