Emerging drugs for the treatment of knee osteoarthritis

Abstract

Further insight into the pathophysiology of the disease will allow for development of novel target classes focusing on the link between symptomatology and structural changes. Given the complexity of OA, one single therapy is unlikely to be universally and uniformly effective. Promising therapies are under development, but there are obstacles in the translation of treatment from preclinical models and trial designs need to be cognizant of the complex reasons for previous trial failures.

Australasian College of Sports Physicians—position statement: the place of mesenchymal stem/stromal cell therapies in sport and exercise medicine

“…Some of the risks and burdens associated with MSC use are well recognised as they arise by virtue of their route of administration (including injection-site infection, and wrong-site administration) 21 112. Other aspects of MSC use where there are, as yet, no clear treatment guidelines may pose risks and potential harms that are yet to be determined, including cell preparation, dose and frequency,12 and any long-term harms that may eventuate 21. There is, therefore, a need to protect the patient from known and as yet unknown harms arising from new and unproven interventions.…”

“…This has been called an ‘unhealthy system’ 11. No published randomised controlled trials for ‘same-day bone marrow stem cell concentrates’ are available as of 2015 10 12…”

Extending the Paradigm of Osteoarthritis: Comment on the Editorial by McAlindon

“…Based on a broad body of evidence, many investigators have proposed that in OA, different combinations of pathogenic mechanisms drive disease in different groups of patients, and each of these groups of patients may respond to different treatments (10)(11)(12)(13)(14)(15). Although attempts have been made to "classify" OA based on anatomic and pathologic features (16), unless these are correlated with different pathogenic mechanisms, they may not alone offer new ways to develop treatments.…”

“…Although attempts have been made to "classify" OA based on anatomic and pathologic features (16), unless these are correlated with different pathogenic mechanisms, they may not alone offer new ways to develop treatments. Research in OA has been successful in identifying an impressive range of candidate molecular mechanisms driving pathology in different joint tissues (10)(11)(12)(13)(14)(15), but there have been few attempts to identi-fy the proportion of patients in which each mechanism is active and contributes to the disease. Until now, we have clearly lacked the techniques and approaches needed to translate the discovery of candidate mechanisms into evidence identifying in which patients and at what stage of disease they are important.…”

Evaluation of MiR-181a as a potential therapeutic target in osteoarthritis

“…Therapeutic options for treatment of OA are primarily limited to management of symptoms, rather than targeting the underlying disease processes [4]. Therefore, there is an urgent need to identify therapeutic targets that are involved in the pathogenesis of OA that in turn would lead to the development of new therapeutics responsible for alteration of key biological processes underlying OA [5].…”