Hügle Thomas
Service de rhumatologie, CHUV, 1011 Lausanne.
Rev Med Suisse. 2020 Mar 11;16(685):500-502.
Osteoarthritis (OA) remains a prevalent and difficult to treat entity, mostly due to its different phenotypes. Varying constellations of mechanic, metabolic and extrinsic factors such as trauma are main drivers of OA. Anti-inflammatory therapy by anti-interleukin 1 did not show a clear effect neither in hand or knee OA whilst it seem to reduce joint replacement at least in a certain patient populations. Corticosteroids did reduce pain and methotrexate reduced structural progression in recent hand OA trials. More promising for mechanical knee OA are growth factors such as sprifermin or kartogenin which foster the differentiation of chondrocytes. New data are available on joint safety of the subcutaneously administered anti-nerve growth factor (NGF) molecule tanezumab. In OA treatment, pain, structure, and biomechanic impairment need to be addressed.
骨关节炎（OA）仍然是一种普遍且难以治疗的病症，主要是由于其不同的表型。机械、代谢和外在因素（如创伤）的不同组合是OA的主要驱动因素。抗白细胞介素1的抗炎疗法在手部或膝部骨关节炎中均未显示出明显效果，尽管它似乎至少在某些患者群体中减少了关节置换。在最近的手部骨关节炎试验中，皮质类固醇确实减轻了疼痛，甲氨蝶呤减缓了结构进展。对于机械性膝骨关节炎更有前景的是生长因子，如司普明或软骨生成素，它们可促进软骨细胞的分化。关于皮下注射抗神经生长因子（NGF）分子他尼珠单抗的关节安全性已有新数据。在骨关节炎治疗中，需要解决疼痛、结构和生物力学损伤问题。
