The current state of the osteoarthritis drug development pipeline: a comprehensive narrative review of the present challenges and future opportunities

• Published in: Therapeutic advances in musculoskeletal disease Vol. 14; p. 1759720X221085952
• Main Authors: Kim, Heungdeok, Seo, Jinwon, Lee, Yunsin, Park, Kiwon, Perry, Thomas A., Arden, Nigel K., Mobasheri, Ali, Choi, Heonsik
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.01.2022; SAGE PUBLICATIONS, INC; SAGE Publishing
• Subjects: Addressing the Challenges Associated with the Development, Testing and Approval of Novel Therapeutics for Osteoarthritis; Drug development; Medical research; Musculoskeletal diseases; Osteoarthritis; Pharmacology; drug development; clinical trials; molecular endotype; osteoarthritis (OA); disease-modifying osteoarthritis drugs (DMOADs); clinical phenotype
• ISSN: 1759-720X; 1759-7218
• DOI: 10.1177/1759720X221085952

In this narrative review article, we critically assess the current state of the osteoarthritis (OA) drug development pipeline. We discuss the current state-of-the-art in relation to the development and evaluation of candidate disease-modifying OA drugs (DMOADs) and the limitations associated with the tools and methodologies that are used to assess outcomes in OA clinical trials. We focus on the definition of DMOADs, highlight the need for an updated definition in the form of a consensus statement from all the major stakeholders, including academia, industry, regulatory agencies, and patient organizations, and provide a summary of the results of recent clinical trials of novel DMOAD candidates. We propose that DMOADs should be more appropriately targeted and investigated according to the emerging clinical phenotypes and molecular endotypes of OA. Based on the findings from recent clinical trials, we propose key topics and directions for the development of future DMOADs.