A meeting of the American College of Rheumatology, held in Atlanta, Georgia, from November 7 to November 11, 2010, showed some modest new successes in understanding osteoarthritis.
Osteoarthritis is characterized by gradual wear of the articular cartilage, cartilage, which covers the ends of long bones. Osteoarthritis primarily affected areas of weight, such as the neck, lower back, hips, and knee.
Osteoarthritis is the most common form of arthritis and affects more than 20 million Americans and is expected to increase in frequency as baby boomers continue to age.
The goal of treatment for osteoarthritis is to relieve pain and improve function. However, the ultimate goal has always been the restoration of articular cartilage.
Some important points from this year’s meetings:
1. Demonstrating that genetic markers called “SNPs” can give an idea of why some people develop osteoarthritis more easily than others. Thus, in addition to cartilage injury, which is a known risk factor for osteoarthritis, there is also a genetic propensity for the disease. Perhaps in the future, patients who are at higher risk of osteoarthritis may be identified and treated more aggressively.
2. Cymbalta (duloxetine), an drug already approved by the FDA for treating major depressive disorder, fibromyalgia, and diabetic peripheral neuropathy, was approved by the FDA for treating chronic musculoskeletal pain, including pain from osteoarthritis and chronic lower back pain The effectiveness of Cymbalta for chronic low back pain and osteoarthritis was evaluated in four double-blind, placebo-controlled, randomized clinical trials. Patients taking Cymbalta in these studies experienced a significantly greater spasm compared with placebo.
3. Data were presented on Naproxcinod, a unique nonsteroidal anti-inflammatory drug. Naproxinod is the first cyclooxygenase inhibitor (CINOD) to inhibit nitric oxide in the treatment of osteoarthritis. It has been found to be comparable to naproxen in its ability to treat pain from osteoarthritis of the hip joint, while at the same time reducing the adverse effects on blood pressure.
4. The popular “new baby on the block,” vitamin D, struck at his reputation. Vitamin D supplementation failed to help patients with osteoarthritis of the knee joint in one study submitted by Tufts University.
5. The use of ultrasound for the injection of the knee for the treatment of osteoarthritis resulted in a 42% reduction in pain, a doubled response rate to therapy and a 15% reduction in the cost of patients compared to conventional injections, guided by "feeling."
6. Pennsaid, a relatively new topical agent that combines the anti-inflammatory effects of diclofenac with the penetrating power of DMSO, has provided some encouraging evidence of pain relief in knee osteoarthritis.
7. Another study showed that the Lidoderm patches provided other possible options for alleviating pain in osteoarthritis of the knee and were superior to placebo.
8. Researchers at the Rush Medical School in Chicago recently examined the baits of 16 adults who were diagnosed with osteoarthritis of the knee through x-rays and reported symptoms. Researchers have found that special shoes can ease pain in the knee and slow the development of pain in the knee and arthritis.
9. A study from the Netherlands showed that distracting the knee (using pins to open the knee joint) actually led to an increase in cartilage and improvement of symptoms, as well as eliminating the need to replace the knee.
10. Two presentations on mesenchymal stem cells gave hope that regeneration of cartilage for the treatment of osteoarthritis is possible in the near future. The first was Dr. Nathan Wei from the Arthritis Treatment Center in Maryland, who presented data on 22 patients who received mesenchymal stem cells for osteoarthritis of the knee. During six months and a year after treatment with autologous stem cells (the patient’s own stem cells), patients showed an improvement in both subjective and objective indicators of cartilage growth. The second report of Dr. Rocky Tuan from the University of Pittsburgh showed that the transformation of adult mesenchymal stem cells into human articular cartilage is not only possible, but also reliable.
