For years, osteoarthritis treatments have focused on relieving symptoms: nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen to control pain, steroid injections to bring down inflammation, and viscosupplements to replace a joint's natural lubricant. The May 2013 Harvard Women's Health Watch looks at some on-the-horizon therapies that could change the way this degenerative disease is treated.
"We're beginning to understand that osteoarthritis is a disease of the entire joint," explains Dr. Antonios Aliprantis, director of the Osteoarthritis Center at Harvard-affiliated Brigham and Women's Hospital. "Much of the research over the last 20 or 30 years has focused on cartilage as the target. But we're beginning to realize that there are important changes happening in the bone underneath the cartilage, and in the joint lining itself. As we begin to understand osteoarthritis as a disease of the entire joint, new treatment targets will emerge."
One treatment in development is a drug called strontium ranelate, which has been used in Europe to treat osteoporosis-related bone loss. It's now finding a new purpose for knee osteoarthritis. Strontium appears to inhibit the activity of cells called osteoclasts, which break down bone. It is possible that in a joint affected by osteoarthritis, strontium ranelate may protect bone under the cartilage.
Stem cells, which are able to transform into many different types of cells, also show potential for treating osteoarthritis. The hope is that injecting stem cells into damaged joints might regenerate healthy tissue.
Osteoarthritisis is a localized disease, so the ideal treatment would be injected directly into the joint. That would avoid the body-wide side effects of current osteoarthritis drugs. Dr. Aliprantis envisions a medication embedded in a gel-like substance that would release the drug slowly into the joint, as it's needed, to repair damaged tissue, "sort of like an on-demand system," he says.
While it may take time for these new therapies to come to fruition, there are several options that can help relieve osteoarthritis pain and stiffness, including:
- oral pain medications such as acetaminophen and NSAIDs (ibuprofen, naproxen)
- topical pain-relieving creams and rubs applied to the skin over the painful joint
- hyaluronic acid injections (viscosupplements) to replace the fluid that naturally lubricates the joint
Read the full-length article: "New ways to beat osteoarthritis pain"