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Osteoarthritis (OA), the most common form of arthritis, is generally
characterized by a slowly progressive degeneration of articular cartilage,
particularly in the weight-bearing joints. It has a stronger prevalence in women,
and its incidence increases with age. OA is a major and growing health concern
in developed countries, owing to steadily increasing life expectancy and the
demand for better quality of life. Because of its chronic nature and nonfatal
outcome, OA affects the growing population of the elderly over an increasing
time span. Moreover, despite its relatively benign character, OA is one of the
most disabling diseases; it is responsible for increasing financial and social
burdens in terms of medical treatments, forced inactivity, loss of mobility, and
dependence.
Despite a growing awareness of OA as a medical problem that has yet to
reach its maximum impact on society, there is a surprising absence of effective
medical treatments beyond pain control and surgery. So far, only symptommodifying
drugs are available, while a major demand remains for diseasemodifying
treatments of proven clinical efficacy. This demand will hopefully
be met in the future by some of the drugs that have been pressed into
development and are now at different stages of clinical investigation.
Nevertheless, the current lack of effective treatments reflects a still insufficient
knowledge of cartilage with respect to its metabolism, interactions with other
joint tissues, and causes and mechanisms (possibly of very different nature)
that lead to failure of its turnover. As is seen in other therapeutic fields, the
future availability of better drugs will depend on a deeper knowledge of OA
physiopathology, allowing rational definition of new molecular targets for
pharmacological intervention. This new interest in OA is fostering an intense
research effort both in academic institutions and in the pharmaceutical industry. |
