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New developments in osteoarthritis pharmacological therapies.

New developments in osteoarthritis pharmacological therapies. Thumbnail


OA is an increasingly common, painful condition with complex aetiology and limited therapies. Approaches to expanding our therapeutic armamentarium have included repurposing existing therapies used for other rheumatological conditions, modifying existing OA preparations to enhance their benefits, and identifying new therapeutics. HCQ and low-dose MTX have been unsuccessful in improving hand OA pain or reducing structural progression. Anti-IL-6 and anti-GM-CSF also did not improve symptoms in hand OA trials, but IL-1 remains an intriguing target for large-joint OA, based on reduced joint replacements in a post hoc analysis from a large cardiovascular disease trial. The peripheral nociceptive pathway appears an attractive target, with mAbs to nerve growth factor and IA capsaicin demonstrating efficacy; tropomyosin receptor kinase A inhibitors are at an earlier stage of development. Limited evidence suggests pharmacological therapies can modify cartilage and bone structural progression, though evidence of synchronous symptom benefits are lacking.

Acceptance Date Aug 31, 2021
Publication Date Dec 24, 2021
Journal Rheumatology
Print ISSN 1462-0324
Publisher Oxford University Press
Pages vi1 - vi11
Keywords OA; cartilage; NSAID; DMARD; inflammation; synovitis; nociceptive pain
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