The current role of disease-modifying osteoarthritis drugs

Document Type : CURRENT CONCEPTS REVIEW

Author

Department of Orthopaedic Surgery, La Paz University Hospital, Madrid, Spain

Abstract

Current treatments for osteoarthritis seek only to relieve the pain associated with the disease. Finding disease-modifying osteoarthritis drugs (DMOADs) that can stimulate joint tissue repair and regeneration would be of significant value. The objective of this article is to review the current role of DMOADs in treating osteoarthritis. We conducted a narrative literature review on the topic, searching the Cochrane Library and PubMed (MEDLINE) using keywords related to the role of DMOADs in osteoarthritis treatment. We have found that numerous studies have investigated the effectiveness of various DMOAD approaches, including anti-cytokine therapy (tanezumab, AMG 108, adalimumab, etanercept, anakinra), enzyme inhibitors (M6495, doxycycline, cindunistat, PG-116800), growth factors (BMP-7, sprifermin), gene therapy (miRNAs, antisense oligonucleotides), peptides (calcitonin) and others (SM04690, senolitic, transient receptor potential vanilloid 4, neural EGFL-like 1, TPCA-1, tofacitinib, lorecivivint and quercitrin). Tanezumab has been shown to relieve hip and knee pain in patients with osteoarthritis but can entail major complications (osteonecrosis of the knee, accelerated disease progression, increased frequency of total replacement of affected joints), especially when tanezumab is combined with nonsteroidal anti-inflammatory drugs. SM04690 (a Wnt inhibitor) has been shown to be safe and effective in reducing pain and improving function as measured by the Western Ontario and McMaster Universities Arthritis Index. The intraarticular injection of lorecivivint is considered safe and well tolerated, with no relevant reported systemic adverse effects. In conclusion, although DMOADs appear promising, their clinical efficacy has not yet been proven for treating osteoarthritis. Until future research can demonstrate the drugs’ ability to repair and regenerate diseased osteoarthritic tissue, clinicians should continue employing treatments that solely aim to relieve pain.

Keywords



Articles in Press, Accepted Manuscript
Available Online from 04 December 2021
  • Receive Date: 06 April 2021
  • Revise Date: 18 September 2021
  • Accept Date: 27 November 2021
  • First Publish Date: 04 December 2021