Biochemical markers of tissue turnover have been used for decades in clinical trials of osteoporosis, but only recently in rheumatoid arthritis. In contrast to serum C-reactive protein (CRP), which is only a nonspecific indicator of systemic inflammation and not directly reflective of structural damage to joints, more recently developed biochemical markers of synovial, cartilage and bone turnover provide a better indication of destructive activity of the disease. Molecular markers are particularly useful for patient selection and treatment, but can be used in a variety of ways to accelerate clinical trials and reduce the uncertainty and cost of drug development.
SYNARC’s founding scientists pioneered the development of a number of biochemical markers of bone, cartilage and synovium to evaluate osteoporosis and rheumatoid arthritis in clinical trials. Dr. Garnero, Vice President of the Molecular Marker Division of SYNARC participated in the development of assays for osteocalcin and type I collagen crosslinks, as markers of bone formation and degradation, respectively. More recently, SYNARC has developed a unique molecular marker specific for the degradation of type II collagen, a major constituent of articular cartilage matrix. Dr. Garnero was one of the first to evaluate the technical performance of these new biochemical markers, to establish their reference ranges in large populations of healthy individuals, and to quantify bone, cartilage and synovium turnover in patients with rheumatoid arthritis.
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