Investigational drugs for the treatment of osteoarthritis, an update on recent developments

ABSTRACT

Introduction: Osteoarthritis (OA) is the leading cause of pain, loss of function, and disability among elderly, with the knee the most affected joint. It is a heterogeneous condition characterized by complex and multifactorial etiologies which contribute to the broad variation in symptoms presentation and treatment responses that OA patients present. This poses a challenge for the development of effective treatment on OA.

Areas covered: This review will discuss recent development of agents for the treatment of OA, updating our previous narrative review published in 2015. They include drugs for controlling local and systemic inflammation, regulating articular cartilage, targeting subchondral bone, and relieving pain.

Expert opinion: Although new OA drugs such as monoclonal antibodies have shown marked effects and favorable tolerance, current treatment options for OA remain limited. The authors believe there is no miracle drug that can be used for all OA patients’; treatment and disease stage is crucial for the effectiveness of drugs. Therefore, early diagnosis, phenotyping OA patients and precise therapy would expedite the development of investigational drugs targeting at symptoms and disease progression of OA.

KEYWORDS:

• ADAMTS
• growth factors
• inflammation
• MMP inhibitors
• osteoarthritis
• pain
• TNF-α inhibitors
• subchondral bone
• therapy

Article highlights

• Current treatment options for OA remain limited as OA is a multifaceted chronic joint disease with multiple aetiologies and different phenotypes.

• Anti-inflammatory therapeutics can be promising approaches to attenuate disease progression of OA.

• Drugs for regulating cartilage metabolism and retarding cartilage degradation are under intense investigation.

• Newly-developed treatments for effective control of OA pain should be long-acting, convenient and safe.

• Subchondral bone may be a potentially OA therapeutic target.

• Early diagnosis, phenotyping and precise therapies are the trends for developing OA therapies.

This box summarizes key points contained in the article.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial relationships or otherwise to disclose.

Additional information

Funding

This paper is not funded.