Skip to main content

Advertisement

SpringerLink
Log in

Pharmacologic therapy of osteoarthritis

  • Published:
Current Rheumatology Reports Aims and scope Submit manuscript

Abstract

This article presents a brief review of the most current therapies that are used for the relief of the symptoms related to osteoarthritis. The agents used either systematically or locally are described, providing the rationale for their usage in the treatment of osteoarthritis. Moreover, new therapies that have reached clinical evaluations and that can possibly reduce or stop the progression of the disease—namely the inhibitors of metalloproteases—are presented. Overall, it is obvious that significant progress has been made toward the development of new therapeutic agents to reduce the symp-toms as well as the structural changes of the disease.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References and Recommended readings

  1. Felson DT, Zhang Y: An update on the epidemiology of knee and hip osteoarthritis with a view to prevention. Arthritis Rheum 1998, 41:1343–1355.

    Article  PubMed  CAS  Google Scholar 

  2. Creamer P, Hochberg MC: Osteoarthritis. Lancet 1997, 350:503–508.

    Article  PubMed  CAS  Google Scholar 

  3. Bradley JD, Brandt KD, Katz BP, et al.: Comparison of an antiinflammatory dose of ibuprofen, an analgesic dose of ibuprofen, and acetaminophen in the treatment of patients with osteoarthritis of the knee. N Engl J Med 1991, 325:87–91. A comparative study on the clinical efficacy of an NSAID, ibuprofen, vis-á-vis acetaminophen at high dosage in knee OA patients.

    Article  PubMed  CAS  Google Scholar 

  4. Bjarnason I, Macpherson A, Rotman H, et al.: A randomized, double-blind, crossover comparative endoscopy study on the gastroduodenal tolerability of a highly specific cyclooxygenase-2 inhibitor, flosulide, and naproxen. Scand J Gastroenterol 1997, 32:126–130.

    PubMed  CAS  Google Scholar 

  5. Zhao SZ, Hatoum H, Hubbard R, et al.: Effect of celecoxib, a novel COX-2 inhibitor, on health-related quality of life of patients with osteoarthritis of the knee. Arthritis Rheum 1997, 40 (Suppl):S88. Novel data on the clinical efficacy of a selective COX-2 inhibitor, cele-coxib, in knee OA patients.

    Google Scholar 

  6. Cruz TF, Tang J, Pronost S, et al.: Molecular mechanisms implicated in the inhibition of collagenase expression by diacerhein. Rev Prat 1996, 46:S15-S19.

    PubMed  CAS  Google Scholar 

  7. Bendele AM, Bendele RA, Hulman JF, et al.: Beneficial effects of treatment with diacerhein in guinea pigs with osteoarthritis. Rev Prat 1996, 46:S35-S39.

    PubMed  CAS  Google Scholar 

  8. Nguyen M, Dougados M, Berdah L, et al.: Diacerhein in the treatment of osteoarthritis of the hip. Arthritis Rheum 1994, 37:529–536.

    Article  PubMed  CAS  Google Scholar 

  9. Marcolongo R, Fioravanti A, Adami S, et al.: Efficacy and tolerability of diacerhein in the treatment of osteoarthritis. Curr Therap Res 1988, 43:878–887.

    Google Scholar 

  10. Mauviel A, Daireaux M, Hartmann DJ, et al.: Effects of unsaponifiable extracts of avocado/soy beans (PIAS) on the production of collagen by cultures of synoviocytes, articular chondrocytes and skin fibroblasts. Rev Rhum Mal Osteoartic 1989, 56:207–211.

    PubMed  CAS  Google Scholar 

  11. Maheu E, Mazieres B, Valat JP, et al.: Symptomatic efficacy of avocado/soybean unsaponifiables in the treatment of osteoarthritis of the knee and hip: a prospective, random-ized, double-blind, placebo-controlled, multicenter clinical trial with a six-month treatment period and a two-month followup demonstrating a persistent effect. Arthritis Rheum 1998, 41:81–91.

    Article  PubMed  CAS  Google Scholar 

  12. Blotman F, Maheu E, Wulwik A, et al.: Efficacy and safety of avo-cado/ soybean unsaponifiables in the treatment of symptomatic osteoarthritis of the knee and hip. A prospective, multicenter, three-month, randomized, double-blind, placebo-controlled trial. Rev Rhum Engl Ed 1998, 64(12):825–834.

    Google Scholar 

  13. Müller-Fasbender H, Bach G, Haase W, et al.: Glucosamine sulfate compared to ibuprofen in osteoarthritis of the knee. Osteoarthritis Cartilage 1994, 2:61–69.

    Article  Google Scholar 

  14. Noack W, Fischer M, Förster KK, et al.: Glucosamine sulfate in osteoarthritis of the knee. Osteoarthritis Cartilage 1994, 2:51–59.

    Article  PubMed  CAS  Google Scholar 

  15. Mazieres B, Loyau G, Menkes CJ, et al.: Chondroitin sulfate in the treatment of gonarthrosis and coxarthrosis. 5-months result of a multicenter double-blind controlled prospective study using placebo (article in French). Rev Rhum Mal Osteoartic 1992, 59:466–472.

    PubMed  CAS  Google Scholar 

  16. L’Hirondel J: Klinische doppelblind-studie mit oral verabre-ichtem chondroitinsulfat gegen placebo bei der tibiofemo-ralen gonarthrose. Litera Rheumatologica 1992, 14:77–84.

    Google Scholar 

  17. Conrozier T, Vignon E: Die wirkung von chondroitinsulfat bei der behandlug der hüftgelenksarthrose. Litera Rheumatologica 1992, 14:69–75.

    Google Scholar 

  18. Morreale P, Manopulo R, Galati M, et al.: Comparison of the antiinflammatory efficacy of chondroitin sulfate and diclofenac sodium in patients with knee osteoarthritis. J Rheumatol 1996, 23:1385–1391. Results from an interesting study comparing the clinical efficacy of a slow acting agent against OA, chondroitin sulfate, to an NSAID, diclofenac, in knee OA patients.

    PubMed  CAS  Google Scholar 

  19. Samuel EP: The autonomic and somatic innervation of the articular capsule. Anat Rec 1952, 113:84–93.

    Article  Google Scholar 

  20. Ralston HJ, Miller MR, Kasahara M: Nerve endings in human fasciae, tendons, ligaments, periosteum and joint synovial membrane. Ann Rheum Dis 1990, 49:649–652.

    Google Scholar 

  21. Kidd BL, Mapp PI, Blake DR, et al.: Neurogenic influences in arthritis. Ann Rheum Dis 1990, 49:649–652.

    Article  PubMed  CAS  Google Scholar 

  22. Deal CL, Schnitzer TJ, Lipstein E, et al.: Treatment of arthritis with topical capsaicin: a double-blind trial. Clin Ther 1991, 13:383–395.

    PubMed  CAS  Google Scholar 

  23. Balch HW, Gibson JM, El-Ghobarey AF, et al.: Repeated corticosteroid injections into knee joints. Rheumatol Rehabil 1977, 16:137–140.

    PubMed  CAS  Google Scholar 

  24. Dieppe PA, Sathapatayavongs B, Jones HE, et al.: Intra-articular steroids in osteoarthritis. Rheumatol Rehabil 1980, 19:212–217.

    Article  PubMed  CAS  Google Scholar 

  25. Friedman DM, Moore ME: The efficacy of intraarticular ste-roids in osteoarthritis: a double-blind study. J Rheumatol 1980, 7:850–856.

    PubMed  CAS  Google Scholar 

  26. Gaffney K, Ledingham J, Perry JD: Intra-articular triamcino-lone hexacetonide in knee osteoarthritis: factors influencing the clinical response. Ann Rheum Dis 1995, 54:379–381. Refreshing insight into the use of corticosteroid injections for the treatment of knee OA patients.

    PubMed  CAS  Google Scholar 

  27. Valtonen EJ: Clinical comparison of triamcinolonehexace-tonide and betamethasone in the treatment of osteoarthrosis of the knee-joint. Scand J Rheumatol Suppl 1981, 41:1–7.

    PubMed  CAS  Google Scholar 

  28. Sambrook PN, Champion GD, Browne CD, et al.: Corticoster-oid injection for osteoarthritis of the knee: peripatellar compared to intra-articular route. Clin Exp Rheumatol 1989, 7:609–613.

    PubMed  CAS  Google Scholar 

  29. Cederlof S, Jonson G: Intraarticular prednisolone injection for osteoarthritis of the knee. A double blind test with placebo. Acta Chir Scand 1966, 132:532–537.

    PubMed  CAS  Google Scholar 

  30. Wada J, Koshino T, Morii T, et al.: Natural course of osteoar-thritis of the knee treated with or without intraarticular corticosteroid injections. Bull Hosp Jt Dis 1993, 53:45–48.

    PubMed  CAS  Google Scholar 

  31. Pelletier JP, Mineau F, Raynauld JP, et al.: Intraarticular injections with methylprednisolone acetate reduce osteoarthritic lesions in parallel with chondrocyte stromel-ysin synthesis in experimental osteoarthritis. Arthritis Rheum 1994, 37(3):414–423.

    Article  PubMed  CAS  Google Scholar 

  32. Namiki O, Toyoshima H, Morisaki N: Therapeutic effect of intra-articular injection of high molecular weight hyaluronic acid on osteoarthritis of the knee. Int J Clin Pharm Ther Tox i c o l 1982, 20:501–507.

    CAS  Google Scholar 

  33. Bragantini A, Cassini M: Controlled single-blind trial of intra-articulary injected hyaluronic acid in osteoarthritis of the knee. Clin Trials J 1987, 24:333–340.

    Google Scholar 

  34. Dixon AS, Jacoby RK, Berry H, et al.: Clinical trial of intra-articular injection of sodium hyaluronate in patients with osteoarthritis of the knee. Curr Med Res Opin 1988,11:205–213.

    PubMed  CAS  Google Scholar 

  35. Dougados M, Nguyen M, Listrat V, et al.: High molecular weight sodium hyaluronate (hyalectin) in osteoarthritis of the knee: a 1 year placebo-controlled trial. Osteoarthritis Cartilage 1993, 1:97–103.

    Article  PubMed  CAS  Google Scholar 

  36. Leardini G, Mattara L, Franceschini M, et al.: Intra-articular treatment of knee osteoarthritis. A comparative study between hyaluronic acid and 6-methyl prednisolone acetate. Clin Exp Rheumatol 1991, 9:375–381.

    PubMed  CAS  Google Scholar 

  37. Pietrogrande V, Melanotte PL, D’Agnolo B, et al.: Hyaluronic acid versus methylprednisolone intra-articularly injected for the treatment of osteoarthritis of the knee. Curr Therap Res 1991, 50:691–701.

    Google Scholar 

  38. Jones AC, Pattrick M, Doherty S, et al.: Intra-articular hyaluronic acid compared to intra-articular triamcinolone hexacetonide in inflammatory knee osteoarthritis. Osteoarthritis Cartilage 1995, 3:269–273.

    Article  PubMed  CAS  Google Scholar 

  39. Scale D, Wobig M, Wolpert W: Viscosupplementation of osteoarthritic knees with hylan: a treatment schedule study. Curr Therap Res 1994, 55:220–232.

    Article  Google Scholar 

  40. Adams ME, Atkinson MH, Lussier AJ, et al.: The role of viscosupplementation with hylan G-F 20 (Synvisc) in the treatment of osteoarthritis of the knee: a Canadian multicenter trial comparing hylan G-F 20 alone, hylan G-F 20 with non-steroidal anti-inflammatory drugs (NSAIDs) and NSAIDs alone. Osteoarthritis Cartilage 1995, 3:213–225. Interesting comparison between the clinical efficacy of NSAID vis-á-vis intraarticular injections of hyaluronic acid in the treatment of knee OA patients.

    Article  PubMed  CAS  Google Scholar 

  41. Graf J, Neusel E, Schneider E, et al.: Intra-articular treatment with hyaluronic acid in osteoarthritis of the knee joint: a controlled clinical trial versus mucopolysaccharide polysulfuric acid ester. Clin Exp Rheumatol 1993, 11:367–372.

    PubMed  CAS  Google Scholar 

  42. Pelletier JP, Martel-Pelletier J, and Howell DS: Etiopathogenesis of osteoarthritis. In Arthritis and Allied Conditions. A Textbook of Rheumatology. Edited by Koopman WJ. Baltimore: Williams & Wilkins; 1997:1969–1984.

    Google Scholar 

  43. Dean DD: Proteinase-mediated cartilage degradation in osteoarthritis [Review]. Semin Arthritis Rheum 1991, 20:2–11.

    Article  PubMed  CAS  Google Scholar 

  44. Pelletier JP, Di Battista JA, Roughley PJ, et al.: Cytokines and inflammation in cartilage degradation. In Osteoarthritis, Edition of Rheumatic Disease Clinics of North America. Edited by Moskowitz RW. Philadelphia: WB Saunders Company; 1993:545–568.

    Google Scholar 

  45. Vincenti MP, Clark IM, Brinckerhoff CE: Using inhibitors of metalloproteinases to treat arthritis. Easier said than done? [Review]. Arthritis Rheum 1994, 37(8):1115–1126.

    Article  PubMed  CAS  Google Scholar 

  46. Yu LP Jr, Smith GN Jr, Brandt KD, et al.: Reduction of the severity of canine osteoarthritis by prophylactic treatment with oral doxycycline. Arthritis Rheum 1992, 35:1150–1159.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Osteoarthritis Research Unit, Centre Hospitalier de l’Universite, de Montreal (CHUM), Hopital Notre-Dame, 1560 Sherbrooke St. E., H2L 4M1, Montreal, Quebec, Canada

    Jean-Pierre Pelletier MD, Denis Choquette MD, Boulos Haraoui MD, Jean-Pierre Raynauld MD, Éric Rich MD, Julio C. Fernandes MD, MSc & Johanne Martel-Pelletier PhD

Authors
  1. Jean-Pierre Pelletier MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Denis Choquette MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Boulos Haraoui MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jean-Pierre Raynauld MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Éric Rich MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Julio C. Fernandes MD, MSc
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Johanne Martel-Pelletier PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Pelletier, JP., Choquette, D., Haraoui, B. et al. Pharmacologic therapy of osteoarthritis. Curr Rheumatol Rep 1, 54–58 (1999). https://doi.org/10.1007/s11926-999-0026-0

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11926-999-0026-0

Keywords

Search

Navigation