Year 2020: New Trends in Pharmacological Treatments for Osteoarthritis

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Background

Osteoarthritis (OA) is the most common rheumatic condition in the world and its prevalence is continuing to rise due to the increasing rates of obesity and longevity of the general population. It is estimated that the number of people affected by this condition will increase by approximately 50% over the next 20 years. Furthermore, OA has a remarkable impact on functional ability and it is one of the major causes of disability. OA has been considered for years as a disease of purely mechanical cartilage degradation, but it is actually recognized as a disorder of the whole joint, not only affecting articular cartilage, but also subchondral bone, ligaments, capsule, synovial membrane, and periarticular muscles. The exact pathogenesis of OA has not yet been fully elucidated, but several mechanical, inflammatory, and metabolic factors seem to have a key role and offer potential therapeutic options.

Currently pharmacological treatments are mostly related to the relief of the symptoms, whereas OA disease-modifying drugs (aimed at reducing symptoms in addition to slowing or stopping the disease progression) are yet to be approved by regulatory agencies. At present, a general agreement on the key management strategies for OA has been reached with international guidelines from different professional and research societies, while controversy remains about some treatment options, such as the use of knee braces and heel wedges, acupuncture, intra-articular hyaluronans, balneotherapy and SySADOAs.
A cure for OA remains elusive and the management of disease is still the subject of debate. Indeed, current pharmacological approaches are largely palliative: no disease modifying osteoarthritis drugs (DMOADs) have garnered regulatory approval for this indication, a particular feature of disease pathogenesis, such as synovitis, has not been identified as the most appropriate therapeutic target. Furthermore, there is still the need to define a personalized phenotype-based approach to the treatment of OA.

The purpose of this Research Topic is to provide an overview of current and emerging OA preclinical (in vitro and in vivo, animal models) and clinical studies testing different drugs for the treatment of OA. In particular, this Topic should cover new evidence on current and future pharmacological therapies for OA, discussing the role of symptomatic and disease modifying drugs and the potential development of regenerative medicine. Furthermore, considering that a major reason for the failure of clinical trials testing different pharmacological treatments for OA is due to the high- heterogeneity of the disease, contributions should also aim to identify a therapeutic phenotype-guided approach.

We welcome, but not limit to, articles covering the themes below:
• Basic research in Osteoarthritis therapy
• Clinical trials on symptomatic drugs
• Clinical trials on SySADOA
• Clinical trials on DMOADs
• Intra-articular therapy
• Biologic Drugs

Types of manuscript: Original Research articles, Review articles as well as short communications

Keywords: Osteoarthritis, symptomatic slow acting drugs for Osteoarthritis;, disease modifying osteoarthritis drugs, hyaluronic acid

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