An update on osteoarthritis therapeutics

Purpose of review: This review addresses recent major developments in symptomatic therapy and the principles of disease modification in osteoarthritis. It emphasizes issues that are of importance to the practicing clinician at a time when researchers in the field are trying to improve ways not only to provide symptomatic relief but also to slow disease progression. Recent findings: The past year has led to a reassessment of the role of cyclooxygenase-2 inhibitors in osteoarthritis therapy and has yielded new information on nutriceuticals such as glucosamine. The relative efficacy of intra-articular injections of agents such as corticosteroid and hyaluronic acid preparations has been assessed. In addition, reports on trials of potentially disease-modifying agents for osteoarthritis have been published. Summary: Because the therapeutic options have been reduced over the past year and the role of nutritional supplements remains unclear, the clinician is faced with a need to reassess osteoarthritis therapy. Although no practical disease-modifying agent for osteoarthritis has been identified, reports such as the recent doxycycline trial reviewed herein provide hope that continued research will soon yield a therapeutic model similar to that used in rheumatoid arthritis, for which some therapeutic agents achieve disease modification and other agents can be added as needed for symptomatic relief.