Pharmacologic therapy for osteoarthritis-the era of disease modification

• Published in: Nature reviews. Rheumatology Vol. 7; no. 1; pp. 13 - 22
• Main Author: Hunter, David J
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.01.2011; Nature Publishing Group
• Subjects: 692/308/153; 692/699/1670/407; Antiarthritic agents; Antirheumatic Agents - therapeutic use; Arthritis; Baby boomers; Biomechanical Phenomena; Cartilage; Clinical trials; Development and progression; Disease Progression; Dosage and administration; Drug therapy; Drug Therapy - trends; Epidemiology; Humans; Medicine; Medicine & Public Health; Osteoarthritis; Osteoarthritis - drug therapy; Osteoarthritis - physiopathology; review-article; Rheumatology; Risk factors; Treatment Outcome; Australia; United States
• ISSN: 1759-4790; 1759-4804
• DOI: 10.1038/nrrheum.2010.178

Current therapeutic strategies for osteoarthritis (OA) are mostly palliative; modifying the structural progression of OA has, therefore, become a focus of drug development. This Review discusses the challenges involved in the discovery and development of disease-modifying OA drugs, and describes specific agents that have shown promise in phase II and III trials. Osteoarthritis (OA) is a prevalent and disabling condition for which few safe and effective therapeutic options are available. Current approaches are largely palliative and in an effort to mitigate the rising tide of increasing OA prevalence and disease impact, modifying the structural progression of OA has become a focus of drug development. This Review describes disease modification and discusses some of the challenges involved in the discovery and development of disease-modifying OA drugs (DMOADs). A variety of targeted agents are in mature phases of development; specific agents that are beyond preclinical development in phase II and III trials and show promise as potential DMOADs are discussed. A research agenda with respect to disease modification in OA is also provided, and some of the future challenges we face in this field are discussed. Key Points Current therapeutic approaches for osteoarthritis (OA) are largely palliative Modifying the structural progression of OA has become a focus of drug development Numerous challenges face those involved in disease-modifying OA drugs (DMOADs) development A number of DMOADs are currently in phase II and III clinical trials