In 2015, arthritis specialists at Toronto Western Hospital enrolled a dozen patients with arthritis-wracked knees in a clinical trial of a stem-cell treatment that researchers hope could one day make artificial joint replacements obsolete. The trial, a Canadian first, won’t be cheap, despite the small number of recruits. To cover the estimated $500,000 cost, the researchers turned to an unconventional source of funding: 10 orthopedic surgeons at UHN’s Toronto Western site who donated a total of $1.25-million of their own money beginning five years ago to kick-start the network’s research into a cure for arthritis. This was the impetus for the Campaign To Cure Arthritis.
The orthopedic surgeons’ decision to raid their own bank accounts to help pay for research is a rare – but not unheard-of – move in Canada, one that was driven in part by how much harder it has become to score publicly funded medical research grants in this country. “We felt very strongly that in order to go to anybody and say, ‘Would you please give me support for this idea?’ we had to have our own commitment beyond just the time and effort we would all have to put in,” said Nizar Mahomed, director of the UNH arthritis program and one of the surgeons who donated $125,000 over five years. “We needed to make a commitment of actual dollars and put skin in the game.” The doctors’ gift prompted a philanthropic avalanche from grateful patients toward a campaign that has now raised $38-million to combat osteoarthritis, a disease that affects 4.6 million Canadians but does not traditionally have the fundraising pull of cancer or heart disease. The upcoming stem-cell experiment is the first human trial to be funded by the campaign.
The Campaign To Cure Arthritis also has the support of the hand surgeons and rheumatologists who have also donated a total of $3 million to the campaign.
Funding the upcoming UHN stem-cell trial through a traditional peer-reviewed grant would have been especially difficult because the project falls squarely in what medical researchers call the “valley of death,” the chasm between basic scientific breakthroughs and late stage clinical trials for which public funding has always been scarce.
“There’s a lot of grunt work that has to happen in between, which isn’t necessarily very sexy or exciting for grants panels, but it’s absolutely essential to get to the clinical trial,” said Sowmya Viswanathan, the associate director of the cell therapy program at UHN. “There’s really very few mechanisms for this bridge funding.” The trial will involve 12 patients between the ages of 40 and 65 with moderate to severe osteoarthritis in their knees. Bone marrow extracted from the back of their hips will be used as a source of mesenchymal stromal cells, or MSCs, which UHN scientists will grow in an incubator for four to six weeks and inject into the patients’ knees. The hope, Dr. Viswanathan said, is that the MSCs will awaken the body’s innate healing ability and spur new cartilage to grow around the damaged joint. But at this point, the main purpose of the trial is to establish that the therapy is safe and to gather the pilot data necessary to ask a public granting agency to fund a larger trial in the future.
“The goal of the model here is not to rely purely on philanthropic funding for the research program, but to get to step one, to get pilot data to then be able to prove to CIHR that what we’re proposing is going to be effective,” Dr. Mahomed said.