Biologic drugs as analgesics for the management of osteoarthritis

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Biologic drugs as analgesics for the management of osteoarthritis

Osteoarthritis (OA) is the most common form of arthritis, affecting millions of people across the world. Although the hallmark of the disease is progressive degeneration of the articular cartilage causing narrowing of the joint space, OA also causes pain, loss of motion, instability and physical disability, thus impairing quality of life.

New treatment options are demanded for osteoarthritis to slow down the structural progression of the disease; current therapies mostly target pain and function with minimal effectiveness. Recently, biologic agents have shown to offer exciting prospects as future OA therapy. A variety of novel therapeutic targets have been identified and there are many clinical trials in patients with OA in an attempt to translate these new treatments into clinical practice.

Biologic agents have dramatic effects in chronic inflammatory diseases, and they hoped to have similar effects in the treatment of OA. The aim of this review was to discuss the current knowledge on the use of commonly used biologic agents (i.e. anti-tumour necrosis factor alpha (anti-TNF alpha) and anti-nerve growth factor (anti-NGF)) for the management of OA.

Scientific literature review of studies with the help of MEDLINE and EMBASE investigating the use of biologic agents for the management of osteoarthritis was conducted. But, the current evidence does not support the use of TNF-alpha in this setting, although a selected subgroup of these patients with a marked inflammatory profile may get benefit from this therapy. On the other hand, some of the trials of anti-NGF treatment have been shown to be effective against pain and functionality improvement, but concerns remain as research continue to address issues of safety related to this treatment.

The anti-cytokine treatments have limited efficacy in patients with chronic osteoarthitic pain. However, anti-NGF therapy is efficacious for the treatment of pain associated with hip and the knee OA. More larger and better designed studies are required in more selected populations to determine whether such therapeutic approaches can improve outcomes in this disabling condition, where treatment armamentarium for this disease is inadequate.


Seminars in Arthritis and Rheumatism

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Biologic drugs as analgesics for the management of osteoarthritis


Theodoros Dimitroulas, Tosin Lambe, Rainer Klocke, George D. Kitas, Rui V. Duarte

Seminars in Arthritis and Rheumatism
Therapeutic, Osteoarthritis (OA), Pain, Joint, Biologic agents, Anti-tumour necrosis factor alpha (anti-TNF alpha), Anti-nerve growth factor (anti-NGF), Literature review, Efficacy, Safety
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