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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


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Dermatology & STDs Paediatric rheumatology Rheumatology Surgery Orthopaedics General practitioner for adults
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