New Trends in Pharmacological Treatments for Osteoarthritis

Abstract

Osteoarthritis (OA) is the leading cause of function loss and disability among the elderly, with significant burden on the individual and society. It is a severe disease for its high disability rates, morbidity, costs, and increased mortality. Multifactorial etiologies contribute to the occurrence and development of OA. The heterogeneous condition poses a challenge for the development of effective treatment for OA; however, emerging treatments are promising to bring benefits for OA management in the future. This narrative review will discuss recent developments of agents for the treatment of OA, including potential disease-modifying osteoarthritis drugs (DMOADs) and novel therapeutics for pain relief. This review will focus more on drugs that have been in clinical trials, as well as attractive drugs with potential applications in preclinical research. In the past few years, it has been realized that a complex interaction of multifactorial mechanisms is involved in the pathophysiology of OA. The authors believe there is no miracle therapeutic strategy fitting for all patients. OA phenotyping would be helpful for therapy selection. A variety of potential therapeutics targeting inflammation mechanisms, cellular senescence, cartilage metabolism, subchondral bone remodeling, and the peripheral nociceptive pathways are expected to reshape the landscape of OA treatment over the next few years. Precise randomized controlled trials (RCTs) are expected to identify the safety and efficacy of novel therapies targeting specific mechanisms in OA patients with specific phenotypes.

Monoclonal Antibodies for Chronic Pain Treatment: Present and Future

“…The NSAID, acetaminophen, and opioid analgesics are most commonly applied to OA for relieving pain; however, their side-effects often restrict their use [ 49 ]. In recent years, there has been substantial progress made in understanding the pathogenesis of OA, and currently, there are emerging treatments targeting inflammation, cartilage metabolism, and subchondral bone remodeling, which may retard the structural progression and induce disease remission [ 50 ].…”

Nesfatin-1 facilitates IL-1β production in osteoarthritis synovial fibroblasts by suppressing miR-204-5p synthesis through the AP-1 and NF-κB pathways

“…OASFs in the joint microenvironment are critical to the progression of OA, increasing proinflammatory cytokine production, which leads to cartilage degradation and bone erosion [ 34 ]. Numerous commercially available arthritis therapeutics target inflammatory cytokines, including IL-1β [ 35 ]. Adipokines are produced and secreted by adipose tissue and are involved in many physiological activities, including glucose and lipid metabolism, and also immune and inflammatory responses [ 36 ].…”

Mesenchymal Stem Cell-Derived Exosomes and MicroRNAs in Cartilage Regeneration: Biogenesis, Efficacy, miRNA Enrichment and Delivery

“…Currently, there is no disease-modifying osteoarthritis drug (DMOAD) that has been approved by the regulatory communities, even though a number of candidates have been or are being tested in phase II and III trials [59]. Promising results have been reported in some of the clinical trials.…”