Osteoarthritis treatments

Unlike rheumatoid arthritis, there is no systemic disease associated with osteoarthritis. Treatment of osteoarthritis is with NSAIDs for their analgesic and anti-inflammatory effects. Corticosteroids are not recommended and disease-modifying drugs are not effective in osteoarthritis. 

Belen kii, (2005) Preparations of Hyaluronic Acid in Osteoarthritis Treatment (in Russian). Medicina, Moscow. 

A meta-analysis of chondroitin sulfate supplementation found 16 publications that fit criteria for inclusion. Criteria included types of joint involvement smdied, study designs, numbers of patients emolled, and pain index variables analyzed.It was concluded that chondroitin sulfate may be useful in osteoarthritis treatment however, results of the published smdies were clouded by concomitant use of analgesics or NSAIDs, thus making conclusions about benefits difficult. Some have suggested that it can be used as an anti-inilammatory without dangerous effects on the stomach, platelets, and kidneys. ... 

Clouet, J. et al.. From osteoarthritis treatments to future regenerative therapies for cartilage. Drug... 

A new generation of antiinflammatory agents having immunosuppressive activity has been developed. The appearance of preclinical and clinical reports suggest that these are near entry to the pharmaceutical market. For example, tenidap (CP-66,248) (12) has been demonstrated to inhibit IL-1 production from human peripheral blood monocytes in culture (55). Clinically, IL-1 in synovial fluids of arthritic patients was reduced following treatment with tenidap. Patients with rheumatoid or osteoarthritis, when treated with tenidap, showed clinical improvement (57,58). In addition to its immunological effects, tenidap also has an antiinflammatory profile similar to the classical NSAIDs (59). Other synthetic inhibitors of IL-1 production are SKF 86002 (20) andE-5110 (21) (55). 

NSAIDs are used as the first-line treatment of rheumatoid arthritis, osteoarthritis, systemic lupus erythematosis and other inflammatory diseases, and are thus amongst the most widely used dtugs in the developed world. This widespread use inevitably entailed a considerable associated morbidity, in particular a high incidence of gastric toxicity. In the USA alone, perforations, ulcers and bleeds lead to the hospitalisation of 100,000 patients per year, and about 15% of these die while under intensive care. 

MA M12 M12.221 ADAMTS4 peptidase Potential drug target for the treatment of osteoarthritis... 

Treatment of inflammatory conditions, such as rheumatoid arthritis, osteoarthritis, and rheumatic fever ... 

Management of inflammatory disorders including rheumatoid arthritis and osteoarthritis, management of mild to moderate pain, treatment of dysmenorrhea Rheumatoid arthritis and osteoarthritis... 

The salicylates and nonsteroidal anti-inflammatory drug (NSAIDs) are important in the treatment of arthritic conditions. For example, the salicylates and NSAIDs are used in the treatment of rheumatoid arthritis (a chronic disease characterized by inflammatory changes within the body s connective tissue) and osteoarthritis (a noninflammatory joint disease resulting in degeneration of the articular cartilage and... 

FIGURE 55-2. Treatment of osteoarthritis. OA, osteoarthritis COX-2, cyclooxygenase-2 CV, cardiovascular Gl, gastrointestinal, IA, intraarticular NSAID, nonsteroidal anti-inflammatory drug PPI, proton pump inhibitor. 

Owing to the lag time between initiation and effect, capsaicin is not used for treatment of acute pain from injury. Instead, topical capsaicin is used for chronic pain from musculoskeletal and neuropathic disorders. Capsaicin preparations have been studied in the treatment of pain from diabetic neuropathy, osteoarthritis, rheumatoid arthritis, postherpetic neuralgia, and other disorders.48 It is often used as an adjuvant to systemic analgesics in these chronic pain conditions. 

KEiniXSH Medications Commonly Used in the Treatment of Osteoarthritis ... 

The first-line agents in the treatment of rheumatoid arthritis are non-steroidal anti-inflammatory drugs such as diclofenac. Diclofenac and indometacin, another NSAID, tend to have similar activity hov/ever, indometacin has a higher incidence of side-effects and therefore diclofenac is more appropriate for initial treatment. Sodium aurothiomalate is classified as a disease-modifying antirheumatic drug and is used as a second-line treatment in rheumatoid arthritis, but has been superseded by methotrexate, administered v/eekly. Paracetamol is often indicated in the management of osteoarthritis. Local intra-articular injections of dexamethasone may be administered for the relief of soft-tissue inflammatory conditions. 

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