NIHR awards Imperial £2.2m for osteoarthritis trial

Imperial was awarded £2.2m by the NIHR to evaluate hormone replacement therapy (HRT) as a treatment for hand pain in post-menopausal women with hand osteoarthritis. The trial is based on a collaboration between Imperial and the Universities of Leeds, Keele, Oxford and Hertfordshire.

The HOPE-E2 study is led by Doctor Fiona Watt, who is a Clinical Associate Professor in Rheumatology, in the Department of Immunology and Inflammation.

Osteoarthritis, the most common form of arthritis, results from the degeneration of articular cartilage which cushions the ends of bones and presents with joint pain and loss of function. Hand osteoarthritis is twice as common in women than men with an increase around 50 years old, the median age of menopause worldwide.

“Hand osteoarthritis affects millions of men and women in the UK and can have a devastating long-term impact on daily activities, ability to work and quality of life,” Dr Watt told Imperial News. “While there is mounting evidence that hormonal changes could play a role in the condition, this has never been tested in a definitive clinical trial.”

While the Women’s Health Initiative, a long-term national health study launched by the NIH, found that women on unconjugated oestrogens had lower incidence of large joint replacement and musculoskeletal pain compared to women given the placebo, the clinical role of HRT has not yet been comprehensively investigated.

HOPE-e2 will test if transdermal oestradiol can reduce hand pain, compared to a placebo, building on the HOPE-e study, which evaluated the feasibility of a randomised controlled trial of HRT for hand arthritis in postmenopausal women The trial began in October and is set to run for 43 months, with participant recruitment beginning in mid-2027.

“Our HOPE-E2 study team aims to provide robust evidence on whether HRT could offer a new treatment for postmenopausal women living with painful hand osteoarthritis,” said Dr Watt.