Molecular Pathogenesis, Clinical Efficacy and Safety of Therapeutics Used in the Treatment of Osteoarthritis

Abstract

Osteoarthritis (OA) also known as degenerative joint disease, is the most common form of arthritis which affects all the tissues of the joint, including the cartilage, bone, ligaments, and muscles. It can develop in any number of joints, but most commonly affects the knees, hands, and hips. OA is characterized by progressive cartilage deterioration, subchondral bone remodeling, loss of joint space, marginal osteophytosis, and loss of joint function. The prevalence rate is estimated to about 242 million people in the world. OA results from the disruption of the balance between synthesis and degradation of extracellular matrix components by the chondrocyte in combination with increased uncompensated chondrocyte apoptosis. It is increasingly understood that ageing contributes to the development of osteoarthritis by working in conjunction with a variety of other factors, both intrinsic and extrinsic to the joint. Several abnormalities in components of the healthy joints such as meniscus, articular cartilage, subchondral bone and synovial membrane results to manifestation the disease. In an attempt to discover new emerging therapeutic target, certain diagnostic strategies are applied such as X-ray, Ultrasonography, Anthroscopy and Magnetic resonance imaging to have a deep insight on its effect and monitor the progression of the disease. Interestingly, many clinical researches proved efficacy of Therapeutics such as Adamulimab which block TNF-α and plays significant role in the pathogenesis of the disease, Diacerein which inhibit interleukin- 1 β, natural anti-inflammatory compound such as curcumin, bisphosphonate drugs such as alendronate and risedronate and anti-osteoporotic drugs such as strontium ranelate, chondroitin sulfate, intraarticular hyaluronic acids and glucosamine sulfate are reported to be effective and safe in the management of the disease.