Abstract
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.