title: Emerging drugs for osteoarthritis.
abstract: BACKGROUND
  Osteoarthritis (OA), the most prevalent form of joint disease, affects as much as 13% of the world's population. In the USA, it is the leading cause of disability in people over age 65 and is characterized by progressive cartilage loss, bone remodeling, osteophyte formation and synovial inflammation with resultant joint pain and disability. There are no treatments marketed for structural disease modification; current treatments mainly target symptoms, with > 75% of patients reporting need for additional symptomatic treatment.
  
  
  METHODS
  Drugs in later development (Phase II - III) for OA pain and joint structural degeneration are reviewed. Topics that are not covered in this article are procedural-based (e.g., arthrocentesis, physical therapy), behavioral-based (e.g., weight loss, pain coping techniques) or device-based (e.g., knee braces, surgical implants) treatments.
  
  
  CONCLUSIONS
  More in-depth understanding of the pathophysiology of the disease, as well as elucidation of the link between clinical symptomatology and structural changes in the joint will likely lead to the development of novel target classes with promising efficacy in the future. Efficacy notwithstanding, there remain significant hurdles to overcome in clinical development of these therapeutics, inherent in the progression pattern of the disease as well as challenges with readouts for both pain and structure modification trials.
authors.affiliation: Genzyme Corporation-Orthopaedics, Framingham, MA 01701, USA. gloria.matthews@genzyme.com
authors.forename: Gloria L
authors.initials: GL
authors.lastname: Matthews
authors.forename: David J
authors.initials: DJ
authors.lastname: Hunter
mesh_terms: D000818:Animals; D018771:Arthralgia / Q000188:drug therapy* / Q000209:etiology; D017322:Clinical Trials, Phase II as Topic; D017326:Clinical Trials, Phase III as Topic; D004353:Drug Evaluation, Preclinical / Q000379:methods; D006801:Humans; D007596:Joints / Q000187:drug effects; D010003:Osteoarthritis / Q000150:complications / Q000188:drug therapy*