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.
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