title: Are estrogen-related drugs new alternatives for the management of osteoarthritis?
abstract: Osteoarthritis (OA) is a chronic degenerative disease involving multiple physiopathological mechanisms. The increased prevalence of OA after menopause and the presence of estrogen receptors in joint tissues suggest that estrogen could help prevent development of OA. This review summarizes OA research with a focus on the effects of estrogen and selective estrogen receptor modulators (SERMs). Preclinical studies and clinical trials of estrogen therapy have reported inconsistent results. However, almost all studies assessing SERM treatment have obtained more consistent and favorable effects in OA with a relatively safety and tolerability profiles. At present, some SERMs including raloxifene and bazedoxifene have been approved for the treatment of osteoporosis. In summary, estrogen-related agents may exert both a direct effect on subchondral bone and direct and/or indirect effects upon the surrounding tissues, including the articular cartilage, synovium, and muscle, to name a few. Estrogen and SERMs may be particularly favorable for postmenopausal patients with early-stage OA or osteoporotic OA, a phenotype defined by reduced bone mineral density related to high remodeling in subchondral bone. At present, no single drug exists that can prevent OA progression. Although estrogen-related drugs provide insight into the continued work in the field of OA drug administration, further research is required before SERMs can become therapeutic alternatives for OA treatment.
authors.affiliation: Department of Orthopedic Surgery, The Affiliated Hospital of North China University of Science and Technology, No. 73 Jianshe South Road, Tangshan, Hebei Province, China.
authors.forename: Ya-Ping
authors.initials: YP
authors.lastname: Xiao
authors.affiliation: Medical Research Center, North China University of Science and Technology, Tangshan, China.
authors.forename: Fa-Ming
authors.initials: FM
authors.lastname: Tian
authors.affiliation: Department of Orthopedic Surgery, Hebei Medical University, Shijiazhuang, China.
authors.forename: Mu-Wei
authors.initials: MW
authors.lastname: Dai
authors.affiliation: Department of Pathology, School of Basic Medical Sciences, North China University of Science and Technology, Tangshan, China.
authors.forename: Wen-Ya
authors.initials: WY
authors.lastname: Wang
authors.affiliation: Department of Orthopedic Surgery, The Affiliated Hospital of North China University of Science and Technology, No. 73 Jianshe South Road, Tangshan, Hebei Province, China.
authors.forename: Li-Tao
authors.initials: LT
authors.lastname: Shao
authors.affiliation: Department of Orthopedic Surgery, The Affiliated Hospital of North China University of Science and Technology, No. 73 Jianshe South Road, Tangshan, Hebei Province, China. zhliu130@sohu.com.
authors.forename: Liu
authors.initials: L
authors.lastname: Zhang
mesh_terms: D000818:Animals; D005260:Female; D006801:Humans; D010003:Osteoarthritis / Q000188:drug therapy*; D020845:Selective Estrogen Receptor Modulators / Q000494:pharmacology*
chemical_list: D020845:Selective Estrogen Receptor Modulators
keywords: Bazedoxifene; Estrogen; Joint; Osteoarthritis; Selective estrogen receptor modulators