Osteoarthritis is a serious disease. It affects more than 300 million people across the world. It’s a leading cause of disability among older adults. Therefore, it has a considerable impact on an individual’s quality of life and a huge economic burden on society.

However, there are currently no approved disease-modifying osteoarthritis drugs (DMOADs) and only symptom relief treatments are available. So there is an unmet need for biomarkers that can accelerate OA drug development by improving the understanding of the mechanism of action and finding the right patients.

We re-developed a highly sensitive and robust sandwich immunoassay, huARGS, for detecting ARGS fragments generated by up-regulated proteases, ADAMTS-4/-5, during osteoarthritis.

In TNF-α plus oncostatin M co-incubated human articular cartilage explants, the release of ARGS fragments quantified by huARGS reached a peak at day3, while the release was reduced by an ADAMTS inhibitor. It confirmed the generation of ARGS fragments by ADAMTS-4/-5.

We also measured huARGS biomarker in 20 OA patients’ serum taken throughout the day for diurnal variation, and on three separate days for inter-day variation. Limited inter-day and intra-day variations were observed.

huARGS biomarker was also measured in a subcohort of a placebo-controlled multicenter phase III OA clinical study that aimed to evaluate the safety and efficacy of salmon calcitonin. We investigated the odds ratio (OR) for the radiographic progression over 24 months of the different quartile groups compared to the highest quartile (Q4) group. The participants in the very low group (Q1) were more likely to progress rapidly than the high group. A similar likelihood was not observed in the low group (Q2) and the moderate group.

In conclusion, huARGS biomarker has the potential to aid drug development in various stages, both as a PD biomarker for testing target engagement of ADAMTSs inhibitors, and identifying progressors who might be more likely to respond to a disease-modifying OA drug treatment.

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