An update on the up and coming therapies to treat osteoarthritis, a multifaceted disease

Abstract

Despite the renewed interest in the search of new compounds for treatment of OA, results have been limited. Novel systemic and IA administered agents are in active development. IA drug administration is particularly an attractive approach because can diminish some of the severe side effects associated with systemic drugs. Indeed, one of the most promising fields for pharmacology innovation in OA is joint injected therapy, as suggested by preliminary data from recent studies using IA sprifermin (rhFGF-18), mesenchymal stem cells or TGF-B1 transduced allogenic chondrocytes. Last, the effort to develop new drugs must be accompanied by the interest for establishing well-defined phenotypes, and only then, a more tailored therapy should be practiced in OA.

<p>Efficacy of a Single Intra-Articular HYMOVIS ONE Injection for Managing Symptomatic Hip Osteoarthritis: A 12-Month Follow-Up Retrospective Analysis of the ANTIAGE Register Data</p>

“…The disease prevalence is approximately 17% in white males and 9% in white women over 60 years of age. 1 Treatment aims to relieve pain and to preserve or restore joint mobility in milder cases, and when the disease stage is more severe, to delay total hip replacement (THR) 2 given the fact that THR, even if 90% effective, 3,4 is associated with substantial adverse effects and relevant mortality rates. 5,6 Pharmacological treatments include acetaminophen as a first option, followed by nonsteroidal anti-inflammatory drugs (NSAIDs) for non-responding patients, to be taken with a gastroprotective agent or a selective COX-2 inhibitor.…”

“…Among these, viscosupplementation (VS) is receiving increasing consideration as a valid option for managing symptoms of mild to moderate hip OA, given the results of recent randomized clinical trials 2,9 and recommendations of expert consensuses. 10,11 Hip VS is normally performed under ultrasound (US) or fluoroscopy guidance.…”

Percepción de efectividad y seguridad de los fármacos de acción lenta para osteoartritis (SYSADOA) en el tratamiento de la artrosis desde la farmacia comunitaria

“…A pesar de que las guías recomiendan iniciar tratamiento no farmacológico en primer lugar [4,6,7] en nuestra muestra no encontramos que ninguno de los pacientes hubiese iniciado tratamiento no farmacoló-gico en primer lugar, por lo que no pudimos comparar la efectividad de los SYSADOA frente a los tratamientos no farmacológicos. No obstante se observó que prácticamente la mitad de los pacientes que sólo tomaban SYSADOA seguía unos hábitos de vida saludables, lo que supone valores más altos que los reflejados en el estudio EVALÚA [24].…”

“…El tratamiento de la enfermedad puede dividirse actualmente en cuatro modalidades terapéuticas: el tratamiento farmacológico, el no farmacológico, el tratamiento intraarticular y la cirugía como última instancia [4,5], si bien se está estudiando el uso de otras terapias [6]. En la tabla 1 se recogen las diferentes modalidades terapéuticas de tratamiento de la artrosis según las guías EULAR [4].…”

Intra-articular Injections for Osteoarthritis: From Bench to Bedside, can we Teach Old Drugs New Tricks?

“…Further research could review the effects of drugs like Botulinum neurotoxin A or cell injection therapies of Mesenchymal Stromal Cells (MSCs) or bring promising novel therapies such as Recombinant Human Fibroblastic Growth Factor (Rh FGF-18) or Transforming Growth Factor Beta (TGF-β) into the clinical setting through case series evaluation [5,6]. However, it is not just rigorous study of already establish treatments that is needed; there is also the need to identify novel therapies.…”