Estrogen-related drugs: New alternatives in osteoarthritis
Osteoarthritis (OA) is a chronic, progressive illness that attacks the joint and slowly leads to its dysfunction. This disease is associated with many physiopathological mechanisms. According to the observational studies, the occurrence of OA is increased immensely in the postmenopausal women. The existence of estrogen receptors in joint tissues brings forward that estrogen could aid in preventing development of OA.
This review encapsulates OA research highlighting the effects of estrogen and selective estrogen receptor modulators (SERMs). The preclinical studies and clinical trials of estrogen therapy have reported inconsistent outcomes. Nevertheless, almost all studies assessing SERM treatment have acquired more consistent and favorable effects in OA with a relatively safety and tolerability profiles. Presently, some SERMs like raloxifene and bazedoxifene have been approved for the treatment of osteoporosis.
Hence, it was inferred that estrogen-related agents may exert direct effect on subchondral bone and direct and/or indirect effects upon the surrounding tissues, example being: the articular cartilage, synovium, and muscle etc. As per phenotype defined by reduced bone mineral density concerned to high remodeling in subchondral bone, estrogen and SERMs may be particularly favorable for postmenopausal patients with early-stage OA or osteoporotic OA. Currently, no signal drug exists that can prevent OA progression. The estrogen related drugs provide insights into the continued work in the field of OA drug administration. Although, further research is needed before SERMs can become therapeutic alternatives for OA treatment.