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Highly Accessed Review

Gene therapy of the rheumatic diseases: 1998 to 2008

Christopher H Evans1*, Steven C Ghivizzani2 and Paul D Robbins3

Author Affiliations

1 Center for Advanced Orthopaedic Studies, Harvard Medical School, BIDMC-RN115, 330 Brookline Avenue, Boston, MA 02215, USA

2 Department of Orthopaedics and Rehabilitation, Florida University College of Medicine, 1600 SW Archer Road, MSB Room M2-210, FL 32610, USA

3 Department of Microbiology and Molecular Genetics, University of Pittsburgh School of Medicine, BST W1246, PA 15261, USA

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Arthritis Research & Therapy 2009, 11:209  doi:10.1186/ar2563

Published: 30 January 2009

Abstract

During the decade since the launch of Arthritis Research, the application of gene therapy to the rheumatic diseases has experienced the same vicissitudes as the field of gene therapy as a whole. There have been conceptual and technological advances and an increase in the number of clinical trials. However, funding has been unreliable and a small number of high-profile deaths in human trials, including one in an arthritis gene therapy trial, have provided ammunition to skeptics. Nevertheless, steady progress has been made in a number of applications, including rheumatoid arthritis and osteoarthritis, Sjögren syndrome, and lupus. Clinical trials in rheumatoid arthritis have progressed to phase II and have provided the first glimpses of possible efficacy. Two phase I protocols for osteoarthritis are under way. Proof of principle has been demonstrated in animal models of Sjögren syndrome and lupus. For certain indications, the major technological barriers to the development of genetic therapies seem to have been largely overcome. The translational research necessary to turn these advances into effective genetic medicines requires sustained funding and continuity of effort.