title: New and emerging treatments for osteoarthritis management: will the dream come true with personalized medicine?
abstract: BACKGROUND
  Osteoarthritis (OA) is a dynamic process involving the main tissues of the joint for which a global approach should be considered. No disease-modifying OA drug (DMOAD) has yet been approved. New therapeutic strategies are needed that would be cost effective by reducing the need for pharmacological interventions and surgical management while targeting specific pathways leading to OA. The treatment landscape of OA is about to change based on new agents having shown some structural effects and emerging therapies with DMOAD effects.
  
  
  METHODS
  In this review based on a Medline (via PubMed) search, promising new and emerging therapies with a potential structural effect (DMOAD) will be discussed including growth factors, platelet-rich plasma, autologous stem cells, bone remodeling modulators, cytokine inhibition, gene therapy, and RNA interference.
  
  
  CONCLUSIONS
  DMOAD development should focus on targeting some phenotypes of OA patients evidenced with sensitive techniques such as magnetic resonance imaging, as a single treatment will unlikely be appropriate for all OA patients. This will allow the development of DMOADs based on personalized medicine. An exciting new era in DMOAD development is within reach, provided future clinical trials are sufficiently powered, systematically designed, use the appropriate evaluation tools, and target the appropriate categories of OA patients.
authors.affiliation: University of Montreal Hospital Research Centre (CRCHUM), Osteoarthritis Research Unit , 1560 Sherbrooke Street East, Montreal, Quebec , Canada.
authors.forename: Camille
authors.initials: C
authors.lastname: Roubille
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Pelletier
authors.forename: Johanne
authors.initials: J
authors.lastname: Martel-Pelletier
mesh_terms: D000818:Animals; D000893:Anti-Inflammatory Agents / Q000494:pharmacology / Q000627:therapeutic use; D016723:Bone Remodeling; D002356:Cartilage / Q000378:metabolism; D015316:Genetic Therapy; D006801:Humans; D010003:Osteoarthritis / Q000378:metabolism / Q000628:therapy*; D057285:Precision Medicine; D034622:RNA Interference
chemical_list: D000893:Anti-Inflammatory Agents