Current Strategies for the Treatment of Early Stage Osteoarthritis

Ji, Xiuling; Zhang, Hongyu

doi:10.3389/fmech.2019.00057

Cited by 20 publications

(16 citation statements)

References 86 publications

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“…Current strategies for the prevention and treatment of OA focus on relieving joint pain and improving joint function by mitigating synovial inflammation and progressive articular cartilage degeneration [ 6 ]. Nonsteroidal anti-inflammatory drugs (NSAIDs) are the primary choice for symptomatic pain relief in patients with osteoarthritis.…”

Section: Introductionmentioning

confidence: 99%

Tamarindus indica Seed Extract-Based Botanical Compositions Alleviate Knee Pain and Improve Joint Function in Mild-to-Moderate Osteoarthritis: A Randomized, Double-Blind, Placebo-Controlled Clinical Study

Kare

Vinay²,

Maresz³

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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Objective. Knee pain and reduced joint function affect the quality of life of subjects suffering from knee osteoarthritis (KOA). The present randomized, double-blind, placebo-controlled study aimed to assess the clinical efficacy of two botanical compositions, NXT15906F6 and NXT19185, in pain relief and improvement in the musculoskeletal function of knee osteoarthritis (KOA) subjects. NXT15906F6 contains ethanol/aqueous extract of Tamarindus indica seeds and aqueous ethanol extract of Curcuma longa rhizome, and NXT19185 is a combination of NXT15906F6 and an aqueous ethanol extract of Garcinia mangostana fruit rind. Methods. The present trial recruited ninety subjects with mild-to-moderate KOA, using a radiographic Kellgren–Lawrence (KL) grading system. The participants were randomized into one of three groups (n = 30) to receive either placebo, NXT15906F6 (250 mg/day), or NXT19185 (300 mg/day) for 56 days. The change in Western Ontario and McMaster Universities Arthritis Index (WOMAC) score was the primary efficacy measure of the study. Improvements in the functional scores, serum proinflammatory modulators, and cartilage degradation product in the urine samples were the secondary efficacy measures. Twenty-seven subjects in each group completed the trial. Results. After the trial, NXT15906F6 and NXT19185 significantly improved P < 0.05 the WOMAC scores from baseline compared with placebo. In the subgroup analyses, the knee pain and functional scores were significantly improved in the KL-II and KL-III grade KOA subjects. At the end of the study, the NXT15906F6- and NXT19185-supplemented participants showed significant P < 0.05 improvement in the functional scores, inflammatory status, and collagen breakdown product in the urine samples. Summary. The present study demonstrates that NXT15906F6 and NXT19185 supplementations reduce knee pain and improve the musculoskeletal function of KOA subjects. Moreover, these herbal compositions helped reduce inflammation and inflammation-induced cartilage degeneration in the participants. NXT15906F6 and NXT19185 supplementations are further documented to be tolerable and safe to the participants.

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Section: Introductionmentioning

confidence: 99%

Tamarindus indica Seed Extract-Based Botanical Compositions Alleviate Knee Pain and Improve Joint Function in Mild-to-Moderate Osteoarthritis: A Randomized, Double-Blind, Placebo-Controlled Clinical Study

Kare

Vinay²,

Maresz³

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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“…In view of OA therapy at the articular cartilage level, biolubricants were also necessary and phosphatidylcholine-based liposomes could act as such or as drug delivery systems to increase the uptake of loaded HA or lubricin [ 148 ]. A more realistic model was lately reported to highlight the synergistic effect of three components—HA, lubricin and phosphatidylcholine lipid—which conferred efficient boundary lubrication as hydration layers and easy restoration upon shear kinematics [ 149 ]. This observation indicates the importance to deliver lipid-based nanostructures encapsulating HA or other compounds of interest, to ensure both lubrication and an anti-inflammatory effect using an IA injectable route of administration for improved and efficient OA therapy [ 6 ].…”

Section: Lipid Nanostructures Loaded With Natural Anti-inflammatory Compounds For Oa Treatmentmentioning

confidence: 99%

Mechanisms and Pharmaceutical Action of Lipid Nanoformulation of Natural Bioactive Compounds as Efficient Delivery Systems in the Therapy of Osteoarthritis

et al. 2021

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Osteoarthritis (OA) is a degenerative joint disease. An objective of the nanomedicine and drug delivery systems field is to design suitable pharmaceutical nanocarriers with controllable properties for drug delivery and site-specific targeting, in order to achieve greater efficacy and minimal toxicity, compared to the conventional drugs. The aim of this review is to present recent data on natural bioactive compounds with anti-inflammatory properties and efficacy in the treatment of OA, their formulation in lipid nanostructured carriers, mainly liposomes, as controlled release systems and the possibility to be intra-articularly (IA) administered. The literature regarding glycosaminoglycans, proteins, polyphenols and their ability to modify the cell response and mechanisms of action in different models of inflammation are reviewed. The advantages and limits of using lipid nanoformulations as drug delivery systems in OA treatment and the suitable route of administration are also discussed. Liposomes containing glycosaminoglycans presented good biocompatibility, lack of immune system activation, targeted delivery of bioactive compounds to the site of action, protection and efficiency of the encapsulated material, and prolonged duration of action, being highly recommended as controlled delivery systems in OA therapy through IA administration. Lipid nanoformulations of polyphenols were tested both in vivo and in vitro models that mimic OA conditions after IA or other routes of administration, recommending their clinical application.

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“…Although this idea has gained interest in the community, only few studies have explored the concept of multitarget therapy. One of the most investigated approaches is the use of dual‐function lubricating drug‐loaded nanoparticles 116 . Fan et al developed HA nano‐micelles containing the inti‐inflammatory molecule, curcumin.…”

Section: Targeting For Ia Drug Deliverymentioning

confidence: 99%

Biomaterial strategies for improved intra‐articular drug delivery

Castro

Garcı́a

Guldberg

2020

J Biomedical Materials Res

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Osteoarthritis (OA) is a joint degenerative disease that has become one of the leading causes of disability in the world. It is estimated that OA affects 50 million adults in the United States. Currently, there are no FDA‐approved treatments that slow OA progression and its treatment is limited to pain management strategies and life style changes. Despite the discovery of several disease‐modifying OA drugs (DMOADs) and promising results in preclinical studies, their clinical translation has been significantly limited because of poor intra‐articular (IA) bioavailability and challenges in delivering these compounds to tissues of interest within the joint. Here, we review current OA treatments and their effectiveness at reducing joint pain, as well as novel targets for OA treatment and the challenges related to their clinical translation. Moreover, we discuss intra‐articular (IA) drug delivery as a promising route of administration, describe its inherent challenges, and review recent advances in biomaterial‐based IA drug delivery for OA treatment. Finally, we highlight the potential of tissue targeting in the development of effective IA drug delivery systems.

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Current Strategies for the Treatment of Early Stage Osteoarthritis

Cited by 20 publications

References 86 publications

Tamarindus indica Seed Extract-Based Botanical Compositions Alleviate Knee Pain and Improve Joint Function in Mild-to-Moderate Osteoarthritis: A Randomized, Double-Blind, Placebo-Controlled Clinical Study

Tamarindus indica Seed Extract-Based Botanical Compositions Alleviate Knee Pain and Improve Joint Function in Mild-to-Moderate Osteoarthritis: A Randomized, Double-Blind, Placebo-Controlled Clinical Study

Mechanisms and Pharmaceutical Action of Lipid Nanoformulation of Natural Bioactive Compounds as Efficient Delivery Systems in the Therapy of Osteoarthritis

Biomaterial strategies for improved intra‐articular drug delivery

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