Emerging Trend in the Pharmacotherapy of Osteoarthritis

Abstract

Osteoarthritis (OA) is a degenerative joint disorder and one of the most prevalent diseases among the elderly population. Due to the limited spontaneous healing capacity of articular cartilage, it still remains challenging to find satisfactory treatment for OA. This review covers the emerging trends of pharmacologic therapies for OA such as traditional OA drugs (acetaminophen, non-steroidal anti-inflammatory drugs (NSAIDs), opioids, serotonin-norepinephrine reuptake inhibitors (SNRIs), intra-articular injections of corticosteroids, and dietary supplements), which are effective in pain relief but not in reversing damage, and are frequently associated with adverse events. Alternatively, disease-modifying drugs provide promising alternatives for the management of OA. The development of these emerging OA therapeutic agents requires a comprehensive understanding of the pathophysiology of OA progression. The process of cartilage anabolism/catabolism, subchondral bone remodeling and synovial inflammation are identified as potential targets. These emerging OA drugs such as bone morphogenetic protein-7 (BMP-7), fibroblast growth factor-18 (FGF-18), human serum albumin (HSA), interleukin-1 (IL-1) inhibitor, β-Nerve growth factor (β-NGF) antibody, matrix extracellular phosphoglycoprotein (MEPE) and inverse agonist of retinoic acid-related orphan receptor alpha (RORα) etc. have shown potential to modify progression of OA with minimal adverse effects. However, large-scale randomized controlled trials (RCTs) are needed to investigate the safety and efficacy before translation from bench to bedside.

The Efficacy of Nerve Growth Factor Antibody for the Treatment of Osteoarthritis Pain and Chronic Low-Back Pain: A Meta-Analysis

“…Osteoarthritis (OA) is a 00degenerative articular disease and is one of the most common di0sorders among the elderly (Zhang et al, 2019). The major symptoms include pain, stiffness, swelling, tenderness, and joint movement disfunction, which has a serious impact on patients.…”

NADPH oxidases in bone and cartilage homeostasis and disease: A promising therapeutic target

“…Osteoarthritis (OA) is a disease of the whole joint, affecting the functional unit of articular cartilage and subchondral bone. [1][2][3][4] While biomechanical stress on the joint is well accepted as an etiologic factor in the development of OA, the cell signaling and biochemical factors involved in its pathogenesis are less appreciated. The progression of OA is associated with changes at the macrostructure of the joint with the formation of marginal osteophytes and erosion of cartilage, as well as the microstructure with changes in the composition of articular cartilage and subchondral bone, turnover of subchondral bone, and loss of demarcation between cartilage and bone at the osteochondral junction.…”

“…The progression of OA is associated with changes at the macrostructure of the joint with the formation of marginal osteophytes and erosion of cartilage, as well as the microstructure with changes in the composition of articular cartilage and subchondral bone, turnover of subchondral bone, and loss of demarcation between cartilage and bone at the osteochondral junction. 1,5,6 Despite significant interest and progress, 4 there is currently no disease-modifying drug for the treatment of OA that may prevent these changes.…”

Emerging Gene-Editing Modalities for Osteoarthritis

“…Current treatments for OA can include intra-articular joint injections of steroids and arthroscopic lavage with debridement; however, these may have short-term benefits without long-term benefit to the cartilage [ 22 , 37 , 38 ]. Anti-inflammatory and analgesic drugs may help to address some of the symptoms of OA, but they do not tackle the fundamental pathologies involved in the inexorable degenerative process, in addition to having significant side effects associated with prolonged use [ 39 , 40 , 41 , 42 ]. Surgery and joint replacement, if possible in the early stages of OA, are expensive and may need to be performed multiple times during an individual’s life [ 22 , 43 ].…”