Biochemical markers in hand osteoarthritis: a path to precision medicine

Hand osteoarthritis (HOA) is a heterogeneous joint disease with high radiographic and symptomatic prevalence. The diagnosis of HOA is based on clinical and radiographic features. The identification of potential biomarkers for diagnosis, prognosis, disease severity assessment, and therapeutic efficacy evaluation of НОА remains an active area of research. To summarize the eligible biomarker data, a comprehensive narrative review was performed using the PubMed and Scopus databases covering publications from inception to December 2024. Our search uncovered five distinct groups of biomarkers associated with HOA, categorized based on their origin and involvement in distinct biological processes: (1) cartilage synthesis and catabolism, (2) bone remodeling, (3) inflammation, (4) adipokines, and (5) others classified separately. Each biomarker was evaluated in accordance with the Burden of disease, Investigative, Prognostic, Efficacy of intervention, and Diagnostic (BIPED) criteria. In conclusion, no biomarker has yet demonstrated sufficient sensitivity, specificity, or reproducibility to meet the BIPED criteria for classification. The early diagnosis and treatment of HOA require the development of more sensitive assays, advanced platforms, and rigorous bio-clinical trials to stratify previously studied biomarkers and identify novel ones. Precision medicine in HOA demands reliable biomarkers, cost-effective assays, and standardized, reproducible methodologies for global applicability.