#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Prospects for the treatment of osteoarthritis


Authors: K. Pavelka
Authors‘ workplace: Revmatologický ústav Praha
Published in: Čes. Revmatol., 23, 2015, No. 1, p. 14-21.
Category: Rewiev

Osteoartróza (OA) je nejčastější kloubní onemocnění. Dosavadní léčba spočívala v kombinaci režimových opatření, fyzikální léčby a farmakoterapie, v případě pokročilé nemoci pak v chirurgickém řešení ­náhradou kloubu. Veškerá farmakologická léčba byla ryze symptomatická. Snahou farmaceutického průmyslu je vyvinout léky, které by modifikovaly strukturální rozpad chrupavky. Tyto léky nazýváme DMOAD (Disease Modifying OsteoArthritis Drugs). Toho času není žádný DMOAD dostupný, ale řada z nich je v procesu klinického zkoušení.

Overview

Osteoarthritis (OA) is the most common joint disease. The existing treatment consists of a combination of lifestyle changes, physical therapy, pharmacotherapy, and surgical joint replacement in case of advanced disease. All pharmacological treatment was purely symptomatic. The aim of the pharmaceutical industry is to develop drugs that modify the structural breakdown of cartilage. These drugs are called DMOAD (Disease Modifying OsteoArthritis Drugs). There is no DMOAD available to date, however many of them are in the process of clinical testing.

This article aims to provide an overview of these methods. Each agent is described with an expected mechanism of action, the experimental data on animal cartilage, and clinical data when available. The author assesses the following approachess: growth factors, blockage of nitrous oxide, stem cell therapy, platelet-rich plasma (PRP) therapy focusing on the subchondral bone (bisphosphonates, strontium ranelate, zoledronate), anti-inflammatory treatment: anti-cytokine therapy, intra-articular injection of autologous conditioned serum and gene therapy. Innovative surgical techniques are listed briefly as well.

Key words:
Osteoarthritis, new therapeutic approaches


Sources

1. Dawson J, Linsell L, Zondervan K, et al. Epidemiology of hip and knee pain and its impal on overall health status in older adults. Rheumatology 2004; 43: 497–504.

2. Kastelein M, Luijsterburg PA, Belo JN, et al. Six-year course and prognosis of nontraumatic knee symptoms in adults in general practice: a prospective cohort study. Arthritis Care Res 2011; 63(9): 1287–94.

3. Goldring MB. Chondrogenesis, chondrocyte differentiation and articular cartilage metabolism in health and osteoarthritis. Ther Adv Musculosceletal Dis 2012; 4: 269–285.

4. Pavelka K, Gatterova J, Olejarova M, et al. Glucosamine sulphate use and delay of progression of knee osteoarthritis. Arch Intern Med 2002;162:2113–23.

5. Kahan A, Uebelhards D, De Vathaire F. Long-term effects of chondroitin sulphates on knee OA. The study on OA progression, prevention, a two year, radnomized, double blind, placebo controlled trial. Arthritis Rheum 2009; 60: 524–33.

6. Dougados M, Nguyen M, Berdah L et al. Evaluation of the structure – modifying effects of diacerein in hip osteoarthritis: ECHODIAH, a three year ,placebo controlled trial. Evaluation of the chondromodulating effect of diacerein in OA of the hip. Arthritis Rheum 2001; 44: 2539–47.

7. Maheu E, Cadet C, Marty M et al. Evaluation of the structure modifying effect of avocado-soybean unsaponifiables (ASU) in hip osteoarthritis. Results of ERADIAS study. A 3 year prospective, randomized, double blind, placebo controlled trial. Osteoarthritis cartilage 18: (Suppl 2)s. 560.

8. Gavenis K, Heussen N, Schmidt-Rohlfing B. Effects of low concentration BMP 7 on human osteoarthritic chondrocytes: comparison of different applications. J Biomater Appl 2012; 26: 845–859.

9. Helio le Gravenerd MP, Clemmer RS, Redifer P, et al. A 2 year randomised, double blind, placebo controlled, multicentre study of oral selective i NOS inhibitor, cindunistat (SD-6010) in patients with symptomatic osteoarthritis of the knee. Ann Rheum Dis 2013; 72: 187–195.

10. Estes BT, Diekman BO, Gimble JM, et al. Isolation of adipose –derived stem cells and thein induction to a chondrogenic phenotype. Nat Protoc 2010; 5: 1294–1311.

11. Johnson K, Zhu S, Trembley MA, et al. A stem cell –based approach to cartilage repair. Science 2012; 336: 717–721.

12. Alfageh H, Norhamdan MY, Chua KH, et al. Cell based therapy for osteoarthritis in a sheep model: gross and histological assessment. Med J. Malaysia 2008; 63: Suppl. 37–38.

13. Emadedin M, Aghdami N, Taghiyar L, et al. Intra-articular injection of autologous mesenchymal stem cells in six patients with knee osteoarthritis. Arch Iran Med 2012; 15(7): 422–428.

14. Koh YG, Jo SB, Kwon OR, et al. Mesenchymal stem cell injections improve symptoms of knee osteoarthritis. Arthroscopy 2013; 29(4): 748–755.

15. Pietrzak WS, An YH, Kang QK, et al. Platelet-rich and platelet-poor plasma: development of an animal model to evaluate hemostatic efficacy. J Craniofac Surg 2007; 18(3): 559–567.

16. Anitua E, Andia I, Ardanza B, et al. Autologous platelets as a source of proteins for healing and tissue regeneration. Tromb Haemost 2004; 91(1): 4–15.

17. Taylor DW, Petera M, Hendry M, Theodoropoulos JS. A systematic review of the use of platelet-rich plasma in sports medicine as a new treatment for tendon and ligament injuries. Clin J Sport Med 2011; 21(4): 344–352.

18. Kon E, Mandelbaum B, Buda R, et al. Platelet-rich plasma intra-articular injection versus hyaluronic acid viscosupplementation as treatments for cartilage pathology: from early degeneration to osteoarthritis. Arthroscopy 2011; 27(11): 1490–1501.

19. Filardo G, Kon E, Di Martino A, et al. Platelet-rich plasma vs hyaluronic acid to treat knee degenerative pathology: study design and preliminary results of a randomized controlled trial. BMC Musculoskelet Disord 2012; 13: 229.

20. Sanchez M, Fiz N, Azofra J, et al. A randomized clinical trial evaluating plasma rich in growth factors (PRGF-Endoret) versus hyaluronic acid in the short term treatment of symptomatic knee osteoarthritis. Arthroscopy 2012; 28(8): 1070–1078.

21. Patel S, Dhillon MS, Aggarwal S, et al. Treatment with platelet-rich plasma is more effective than placebo for knee osteoarthritis: a prospective, double-blind, randomized trial. Am J Sports Med 2013; 41(2): 356–364.

22. Mapp PI, Walh DA, et al. Mechanism and targets of angiogenesis and nerve growth in osteoarthritis. Nat Rev Rheumatol 2012; 8: 390–398.

23. Pelletier JP, Troncy E, Bertaim T, et al. Treatment with tiludronic acid helps reduce the development of experimental osteoarthritis lesions in dogs with anterior cruciate ligament transection followed by reconstructive surgery: a 1-year study with quantitative magnetic resonance imaging. J Rheumatol 2011; 38(1): 118–128.

24. Carbone LD, Nevitt MC, Wildy K, et al. The relationship of antiresorptive drug use to structural fundings and symptoms of knee osteoarthritis. Arthritis Rheum 2004; 50(11): 3516–3525.

25. Spector TD, Conaghan PG, Buckland-Wright JC, et al. Effect of risedronate on joint structure and symptoms of knee osteoarthritis: results of the BRISK radnomized, controlled trial (ISRCTN01928173). Arthritis Res Ther 2005; 7(3): R625–633.

26. Henrotin Y, Labasse A, Zheng SX, et al. Strontium ranelate increases cartilage matrix formation. J Bone Miner Res 2001; 16(2): 299–308.

27. Reginster JY, Badurski J, Bellamy N, et al. Efficacy and safety of strontium ranelate in the treatment of knee osteoarthritis: results of a double-blind, randomised placebo-controlled trial. Ann Rheum Dis 2013; 72(2): 179–186.

28. Laslett LL, Dore DA, Quinn SJ, et al. Zoledronic acid reduces knee pain and bone marrow lesions over 1 year: a randomised controlled trial. Ann Rheum Dis 2012; 71(8): 1322–1328.

29. Manicourt DH, Azria M, Mindeholm L, et al. Oral salmon calcitonin reduces Lequesne´s algofunctional index scores and decreases urinary and serum levels of biomarkers of joint metabolism in knee osteoarthritis. Arthritis Rheum 2006; 54(10): 3205–3211.

30. Esenyel M, Icagasioglu A, Esenyel CZ. Effects of calcitonin on knee osteoarthritis and quality of life. Rheumatol Int 2013; 33(2): 423–427.

31. McAlindon T, LaValley M, Schneider E, et al. Effect of vitamin D supplementation on progression of knee pain and cartilage volume loss in patients with symptomatic osteoarthritis: a randomized controlled trial. JAMA 2013;3 09(2):155–162.

32. Chevalier X, Goupille P, Beaulieu AD, et al. Intraarticular injection of anakinra in osteoarthritis of the knee: a multicenter, randomized, double-blind, placebo-controlled study. Arthritis Rheum 2009; 61(3): 344–352.

33. Cohen SB, Proudman S, Kivitz AJ, et al. A randomized, double-blind study of AMG 108 (a fully human monoclonal antibody to IL-1R1) in patients with osteoarthritis of the knee. Arthritis Res Ther 2011; 13(4): R125.

34. Verbruggen G, Wittoek R, Vander Cruyssen B, et al. Tumour necrosis factor blockade for the treatment of erosive osteoarthritis of the interphalangeal finger joints: a double blind, randomised trial on structure modification. Ann Rheum Dis 2012; 71(6): 891–898.

35. Yang KG, Raijmakers NJ, van Arkel ER, et al. Autolgous interleukin-1 receptor antagonist improves function and symptoms in osteoarthritis when compared to placebo in a prospective randomized controlled trial. Osteoarthritis Cartilage 2008; 16(4): 498–505.

36. Baltzer AW, Moser C, Jansen SA, et al. Autologous conditioned serum (Orthokine) is an effective treatment for knee osteoarthritis. Osteoarthritis Cartilage 2009; 17(2): 152–160.

37. Fernandes J, Tardif G, Martel-Pelletier J, et al. In vivo transfer of interleukin-1 receptor antagonist gene in osteoarthritic rabbit knee joints: prevention of osteoarthritis progression. Am J Pathol 1999; 154(4): 1159–1169.

38. Evans CH, Ghivizzani SC, Robbins D.: Arthritis gene therapy and its tortuous path into the clinic. Translational Res 2013; 161: 205–216

Labels
Dermatology & STDs Paediatric rheumatology Rheumatology Surgery Orthopaedics General practitioner for adults
Topics Journals
Login
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account

#ADS_BOTTOM_SCRIPTS#