Project’s pathways towards impact: Osteoarthritis affects over 135 million people and it is the fourth and the eight most frequent cause of health problems in women and men worldwide. The trend of increase of OA in Europe was 54% since 1990[1]. Osteoarthritis was observed to have a 104.9% rise in DALYs (or 8.8% when age-standardized) from 1990 to 2016. The incidence 375/million [Range: 322 to 428] and prevalence 4294,3/100 000 [Range: 3695,0 to 4910,8] of KOA[2] is represented by 12,0/millions life lost by disability (YLDs) [Rate: 137,6/ 100.000] and 12.0/million DALYs [Rate: 137,6/ 100.000]. The burden is increasing in aging societies and females[3]. In 2019, the loss of healthy life in Western Europe was about two million years. Osteoarthritis is also not rare in the younger population due to increasing sports and workplace injuries[4]. Pain and loss of function decreases quality of life and worsens mental health. This also negatively impacts societal well-being and increases the indirect burden. The direct and indirect cost of OA due to loss of productivity was 7.2 bn and 4.6 bn. Most patients in Europe furthermore have limited access to non-pharmacological treatment. There is also a significant burden for the older population, which is a particular issue in the lower income countries where interventions are costly and/or have long waiting times due to limited infrastructure, consumables and healthcare staff.
Knee OA and in a broader sense OA is not only a physical but also a psychological and societal burden that needs a new definition and a new dimension. The core of this proposal is the designing and data harmonization strategy of the AI platform that will work together with the Europe-wide clinical registry. These platforms will be created by computer scientists and engineers. Medical specialists will assess the existing data and they will include new data into the registry including motion analysis and multi-omics data. Multiple layered retrospective, cross-sectional and prospective studies will be designed. This inter- and trans-disciplinary project will be carried out by medical doctors of various disciplines, pharmacists, biologists, analytical chemists, engineers, computer scientists and biomedical scientists. Scientific outcomes such as congress presentations, scientific manuscripts and book chapters are therefore expected to reach a broader society then a single disciplines research. Congress presentations that publish their abstracts in well-known media, which are also cited in Web of Science (WoS) will be prioritized. Articles will be published in higher quartile peer-reviewed journals on data science, medicine and omics. Publication in the open research Europe platform[5] will be prioritized for important key manuscripts. Not only book chapters but also books are planned to be published with respected publishers. As defined in WP8, a dissemination of information plan will be released immediately after the acceptance of the project and a road map will be created. This road map will be updated yearly with new outputs. The web page and social media platforms will be created upon acceptance. Apart from scientific manuscripts, electronic bulletins, newsletters, brochures and handouts will be published through this web site. Together with patient societies, media briefings will be organized on special occasions such as the World OA Day. Webinars and seminars will be recorded and displayed at the web site. Workshops and surveys will be carried out in target groups. Young researchers such as Master of Science, PhD and Medical Specialization students will complete their graduation thesis in the scope of this project. The estimated total number of graduation thesis is expected to be 16. After graduation, these students are expected to continue their careers as post-doc in academia, may join governmental-regulatory bodies and/or take part as qualified researchers in industry. Towards the end of the project, new research projects will be generated and launched. The biosensor platforms and new therapeutics have the potential for patent application[6]. These new products will establish an economic and technological impact. These new products will allow easy and low-cost screening of OA patients’ disease progression and/or response to treatments. Assessing treatment efficiency will decrease diagnostic and therapeutic costs. After receiving the patent, the consortium will look forward to licensing the patents. Intellectual property rights will appear in the consortium agreement. The ultimate aim is to convince regulatory bodies such as the European Medical Agency, British or Turkish Standards Institutions. A new perspective into OA diagnosis and response to treatment will set new standards that will decrease the burden of the disease.
When societal impact is prioritized, close communication with patient societies will increase the impact of the project outcomes. The core of the consortium are also members of the EU-COST-CA21110 Action[7] entitled NetwOArK[8] the “European Network on Osteoarthritis”. The main aim of this action is to set up the European Society for Osteoarthritis (EUSOA).
All consortium members are extremely conscious of environmental issues. The consortium has agreed to run the project paperless. Bulletins, newsletters, brochures and handouts will be disseminated through the web site as much as possible. Meetings will be as much as possible organized in the virtual environment to decrease meeting carbon footprints. Using servers and computers consumes inevitable energy. The motion analysis MAI also runs on servers. Participants will search for optimum methods to decrease energy consumption. Collecting human blood and SJF samples needs consumables. These will be disposed of according to medical waste management regulations. Blood and SFJ samples will be allocated and stored at -20°C. While storing, medical grade and low-energy consuming freezers will be preferred. The LC/MS qTOF devices run on chemicals. Waste after analysis will be disposed of according to waste management regulations. A potential harm during any stage of the project is not expected.
The global osteoarthritis therapeutics market is experiencing significant growth. It was valued at $7.96 billion in 2023 and is projected to reach $15.86 billion by 2031. The increasing global aging population is a primary driver, as age is a major risk factor for osteoarthritis. There is a growing demand for less invasive treatments[9]. A key driver in applying new therapies will be improved diagnostic tools such as those proposed by NOOA. Additionally, AI is an emerging opportunity for tailored treatments for osteoarthritis patients[10]. Value for money therapies such a nucleic acid delivery will be required to produce products that have the potential to be applied to a large patient population. Creating an innovative new AI platform and establishing a multi-center KOA clinical registry will allow the combination of the demographic, clinical, imaging, bio-sample, biomarker, multi-omics and biomechanical high-quality data from existing historical collections and ongoing clinical trials with new data inclusion for future assessment. Inclusion of new numerical data from MAI and multi-omics and evaluating this data using AI may bring new insights into OA diagnosis, progression of the disease and predicting treatment outcomes. This approach will aid a sharp decrease in YLDs and DALYs. The target population is mostly women as they are subjected to the disease more than men and their longevity is higher. A self-sufficient lifestyle in senior women is therefore targeted. Using the MAI technology will help the longitudinal evaluation of OA in patients. A decrease in joint angulation during sit and stand tests will immediately be recorded. Biosensors will enable timely intervention. Particularly, the global biosensors market was valued at over $28.5 billion in 2022 and is expected to grow at a 7.4% compound annual growth rate (CAGR), reaching approximately $58.37 billion by 2032, driven by demand for real-time, non-invasive diagnostics in healthcare. OA biosensors, a promising niche within this market, offer early detection and monitoring capabilities, crucial for managing the rising prevalence of OA due to aging populations. With advancements in microfluidics and sensor technology, these biosensors are well-positioned to meet the growing need for personalized, point-of-care solutions. North America and Europe lead in biosensor adoption, while emerging markets like Asia-Pacific present significant growth opportunities.
References:
[1] https://osteoarthritisineurope.eiu.com/
[2] https://www.healthdata.org/research-analysis/diseases-injuries-risks/factsheets/2021-osteoarthritis-knee-level-4-disease
[3] Cao F, Xu Z, Li XX, Fu ZY, Han RY, Zhang JL, Wang P, Hou S, Pan HF. Trends and cross-country inequalities in the global burden of osteoarthritis, 1990-2019: a population-based study, Ageing Research Reviews 2024 (In Press)
[4] Duong V, Oo WM, Ding C, Culvenor AG, Hunter DJ. Evaluation and treatment of knee pain: A review. JAMA 2023;330:1568-1580.
[5] https://open-research-europe.ec.europa.eu/
[6] https://www.gminsights.com/industry-analysis/biosensors-market
[7] https://www.cost.eu/actions/CA21110/
[9] https://www.databridgemarketresearch.com/reports/global-osteoarthritis-therapeutics-market
[10] https://www.marketsandmarkets.com/Market-Reports/osteoarthritis-therapeutics-market-209565994.html