A New Approach to Treating Osteoarthritis
Researchers are pushing the boundaries to provide new treatment opportunities for OA patients.
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Osteoarthritis (OA) affects millions of people worldwide, particularly those in older age groups. The disease is often poorly managed, with current therapies primarily focusing on pain relief and physiotherapy until a joint replacement becomes necessary. Despite being the most common form of arthritis, affecting both young and older individuals, OA lacks effective treatments that can slow or reverse its progression.
At the BioTrinity 2025 conference, researchers Dr. Francesco Dell’Accio, professor of musculoskeletal regenerative medicine and rheumatology, and Dr. Suzanne Eldridge, senior lecturer in musculoskeletal regenerative medicine, announced the launch of ReFleks, a spinout company from Queen Mary University London dedicated to developing diagnostic strategies, prevention and treatments for OA.
Given the complexity and variability of OA, much more research is needed to better understand the disease and develop therapies that can be tailored to individual patients. In this interview, Technology Networks spoke with Dell’Accio and Eldridge to explore the impact of OA on patients, the goals of ReFleks and a novel approach to repairing osteochondral defects.
What interested you the most about creating a spinout company to support OA patients?
Professor Francesco Dell’Accio (FD):
Suzanne Eldridge, PhD (SE):
IE:
How does OA impact the daily lives of patients, particularly those with advanced disease?
SE:
For patients with advanced OA, everyday tasks become a struggle – getting in and out of the bathtub, doing the shopping or even getting to work. A joint replacement can restore some independence, but it doesn’t return full function. Today, people expect to lead an active lifestyle well into their 60s, 70s or even 80s. Yet, for a growing number of people, OA is affecting them younger in life, with sports injuries being a major cause of early OA. For these patients, joint replacement isn’t an ideal solution.
Moreover, joint replacements only last about 10 years and revisions involve serious surgery. To minimize the need for revisions, orthopedic surgeons try to delay knee replacements for as long as possible. While patients may feel better after receiving a joint replacement, they often spend many years living with severe disability, waiting for their OA to worsen enough to justify the procedure. In 2025, this is simply unacceptable.
FD:
Not only does this lead to years of disability, but it also prevents people from exercising due to joint pain, which increases their risk for cardiovascular disease, obesity, and diabetes – conditions that are leading causes of death.
For all these reasons, despite the availability of joint replacements, the US Food and Drug Administration has recognized OA as a serious disease and granted fast-track regulation to potential drugs that could reverse its progression. This is because, currently, there are no effective treatments to halt or reverse the disease.
IE:
Could you tell our readers more about ReFleks? What is its aim and how does the app work?
SE:
The main goal of ReFleks is to bring to market a fragment of the protein Agrin, which has the potential to trigger cartilage regeneration. ReFleks will complete the necessary studies before advancing to human trials and will also conduct early clinical studies. In addition, ReFleks has developed an app that allows individuals to monitor their level of osteoarthritis and track their response to interventions.
While Agrin is not yet available, patients can still use the app to track improvements or worsening of symptoms and physical function, for example, in response to weight loss or muscle strengthening. The app is available for free download on the Apple Store and Google Play Store.
IE:
Very few OA patients worsen within a short time (i.e., a year), making it very difficult and costly to create treatments. Can you tell us more about how the North East London Osteoarthritis (NELOA) study hopes to address this?
FD:
The NELOA cohort will focus on patients with recent knee trauma, many of whom will go on to develop OA. Within the NELOA study, we will collect blood and joint tissue samples to identify a blood test that can determine whether a patient is at risk. If positive, the test will indicate that the patient may require Agrin in their joint to prevent further cartilage loss. This approach ensures that we don’t treat everyone, which would be financially unsustainable for the NHS, and we only administer treatments to those who are likely to benefit. The NELOA cohort will help us learn how to treat patients responsibly and selectively, ensuring our interventions are targeted and effective.
IE:
At the BioTrinity conference, you announced that you have discovered a new way to repair osteochondral defects. Can you elaborate on this treatment and what it involves?
SE:
We’ve developed a fragment of Agrin, a protein naturally present in the body, that can be injected directly into the knee – no surgery required. This injection triggers cartilage regeneration by activating specialized repair cells, or stem cells, and directing them to repair the cartilage.
In recent years, researchers have been able to repair cartilage by extracting these cells from the knee, isolating and growing them and then reintroducing them into the injury site with a second surgical intervention. While this approach works, it is complex, prohibitively expensive and the results can be inconsistent due to the individualized nature of the process.
With Agrin, we no longer need to go through this complicated procedure. The cells are already in the joint – all we need to do is 'communicate' with them and instruct them to repair the cartilage. This is the breakthrough we've achieved with Agrin: we've learned how to activate these cells without the need to remove, grow and reintroduce them.
IE:
How do you see your field of research evolving in the next 5–10 years?
FD:
We hope that in the coming years, multiple molecules will emerge, ensuring that every patient with cartilage loss – whether isolated or diffuse, as in osteoarthritis – can have their joints treated effectively. I hope that, in the near future, I won’t feel that sinking sensation every time an OA patient enters my office. I look forward to being able to say, 'Yes, there is damage to your cartilage, but don’t worry, there are now several options available to you.' It will be a far cry from what we experienced 10 years ago.
We are convinced that cartilage loss occurs through different mechanisms in different patients, so we believe that various molecules will be needed to address the needs of all patients. We will also need specific criteria to identify which patients will benefit from one molecule over another; much research will be focused in this direction as well.
