Emerging targets and therapeutic approaches for the treatment of osteoarthritis pain.
OBJECTIVE
Osteoarthritis is a complex and often painful disease that is inadequately controlled with current analgesics. This review discusses emerging targets and therapeutic approaches that may lead to the development of better analgesics.


RESULTS
Aberrant excitability in peripheral and central pain pathways drives osteoarthritis pain, reversing this via modulation of nerve growth factor, voltage-gated sodium channel, voltage-gated calcium channel and transient receptor potential vanilloid one activity, and increasing inhibitory mechanisms through modulation of cannabinoid and descending modulatory systems hold promise for osteoarthritis pain therapy. Somatosensory phenotyping of chronic pain patients, as a surrogate of putative pain generating mechanisms, may predict patient response to treatment.


CONCLUSIONS
Identification of new targets will inform and guide future research, aiding the development of more effective analgesics. Future clinical trial designs should implement sensory phenotyping of patients, as an inclusion or stratification criterion, in order to establish an individualized, mechanism-based treatment of osteoarthritis pain.
Department of Neuroscience, Physiology and Pharmacology, University College London, London, UK.
Wahida
W
Rahman
Anthony H
AH
Dickenson
D000700:Analgesics / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D059350:Chronic Pain / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology; D002986:Clinical Trials as Topic / Q000379:methods; D015195:Drug Design; D004357:Drug Synergism; D004359:Drug Therapy, Combination; D006801:Humans; D058990:Molecular Targeted Therapy; D009437:Neuralgia / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D010003:Osteoarthritis / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology; D010641:Phenotype; D057285:Precision Medicine / Q000379:methods*
D000700:Analgesics