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01-01-2015 | Osteoarthritis | Book Chapter | Article

10. Drug/Agent Treatments for Osteoarthritis: Present and Future

Authors: Camille Roubille, MD, Jean-Pierre Pelletier, MD, Johanne Martel-Pelletier, PhD

Publisher: Springer International Publishing

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Abstract

  • Osteoarthritis (OA) management is currently based on a wide spectrum of therapeutic options to relieve pain, but other OA drugs with disease-modifying properties (DMOADs) are being developed.
  • There are presently agents that are symptomatic slow-acting drugs for OA (SYSADOA), which not only reduce joint pain but could also slow the structural disease progression in the joint.
  • Targeting cartilage changes (catabolism and anabolism), subchondral bone remodeling, and synovial inflammation are the three main thrusts of research in DMOAD development. Promising emerging therapies include platelet-rich plasma (PRP), bone remodeling modulators, and inflammatory inhibitors.
  • OA should be considered a dynamic process and may be a systemic disease with several tissues and pathways to target for DMOAD development.
  • With the advent of DMOADs, physicians should aim at treating the “patient” rather than the “disease.” Combining therapeutics at both local and systemic levels to impact both symptoms and joint structural changes will likely be the future strategy instead of a sole drug, at least at the beginning of the treatment.
  • Selectively targeting some phenotypes of OA patients evidenced by sensitive tools, such as magnetic resonance imaging (MRI), may allow the development of DMOADs based on personalized medicine.
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