Rodriguez-Merchan E Carlos
Department of Orthopedic Surgery, la Paz University Hospital-IdiPaz, Madrid, Spain.
Arch Bone Jt Surg. 2023;11(1):11-22. doi: 10.22038/ABJS.2021.56530.2807.
Contemporary treatments for osteoarthritis (OA) pursue only to alleviate the pain caused by the illness. Discovering disease-modifying osteoarthritis drugs (DMOADs) that can induce the repair and regeneration of articular tissues would be of substantial usefulness. The purpose of this manuscript is to review the contemporary role of DMOADs in managing OA. A narrative literature review on the subject, exploring the Cochrane Library and PubMed (MEDLINE) was performed. It was encountered that many publications have analyzed the impact of several DMOAD methods, including anti-cytokine therapy (tanezumab, AMG 108, adalimumab, etanercept, anakinra), enzyme inhibitors (M6495, doxycycline, cindunistat, PG-116800), growth factors (bone morphogenetic protein-7, sprifermin), gene therapy (micro ribonucleic acids, antisense oligonucleotides), peptides (calcitonin) and others (SM04690, senolitic, transient receptor potential vanilloid 4, neural EGFL-like 1, TPCA-1, tofacitinib, lorecivivint and quercitrin). Tanezumab has been demonstrated to alleviate hip and knee pain in individuals with OA but can cause major adverse events (osteonecrosis of the knee, rapid illness progression, augmented prevalence of total joint arthroplasty of involved joints, particularly when tanezumab is combined with nonsteroidal anti-inflammatory drugs. SM04690 (a Wnt inhibitor) has been demonstrated to be safe and efficacious in alleviating pain and ameliorating function as measured by the Western Ontario and McMaster Universities Arthritis Index. The intraarticular injection of lorecivivint is deemed safe and well tolerated, with no important reported systemic complications. In conclusion, even though DMOADs seem promising, their clinical effectiveness has not yet been demonstrated for managing OA. Until forthcoming studies can proved the medications' capacity to repair and regenerate tissues affected by OA, physicians should keep using treatments that only intend to alleviate pain.
骨关节炎(OA)的当代治疗方法仅致力于缓解该疾病所引起的疼痛。发现能够诱导关节组织修复和再生的疾病改善性骨关节炎药物(DMOADs)将具有重大意义。本手稿的目的是回顾DMOADs在OA管理中的当代作用。针对该主题进行了叙述性文献综述,检索了考克兰图书馆和PubMed(MEDLINE)。发现许多出版物分析了多种DMOAD方法的影响,包括抗细胞因子疗法(他尼珠单抗、AMG 108、阿达木单抗、依那西普、阿那白滞素)、酶抑制剂(M6495、强力霉素、辛度司他、PG - 116800)、生长因子(骨形态发生蛋白 - 7、司普立明)、基因疗法(微小核糖核酸、反义寡核苷酸)、肽(降钙素)以及其他(SM04690、衰老溶解剂、瞬时受体电位香草酸受体4、神经表皮生长因子样蛋白1、TPCA - 1、托法替布、洛雷西维、槲皮素)。他尼珠单抗已被证明可缓解OA患者的髋部和膝部疼痛,但可能会导致严重不良事件(膝关节骨坏死、疾病快速进展、受累关节全关节置换术的发生率增加,尤其是当他尼珠单抗与非甾体抗炎药联合使用时)。SM04690(一种Wnt抑制剂)已被证明在减轻疼痛和改善功能方面是安全有效的,这是通过西安大略和麦克马斯特大学关节炎指数来衡量的。关节内注射洛雷西维被认为是安全且耐受性良好的,没有重要的全身性并发症报告。总之,尽管DMOADs似乎很有前景,但它们在OA管理中的临床有效性尚未得到证实。在未来的研究能够证明这些药物修复和再生受OA影响组织的能力之前,医生应继续使用仅旨在缓解疼痛的治疗方法。