Osteoarthritis: Significant unmet needs

Osteoarthritis (OA) strikes a large number of patients in the US and around the globe. An estimated 21 million Americans suffer from OA. OA, or degenerative joint disease, is one of the oldest and most common types of arthritis. It is characterized pathologically by the breakdown of the joint’s cartilage with a consequent inflammatory response. Cartilage is the part of the joint that cushions the ends of bones. It provides a near frictionless surface with which the bones articulate within a joint. As the disease process continues to degrade the cartilage, there is a progressive decrease in function and, in some patients, increased pain, especially when weight-bearing or with use of the joint. To the right are depictions of a healthy joint, and one with OA.

A diagnosis of OA is based primarily on the patient’s history of symptoms and a physical examination. Radiography is considered the “gold standard” test for OA and is often used in conjunction with patient history to confirm a diagnosis of OA. Laboratory tests play a minor role in diagnosing OA but are sometimes used to exclude other, inflammatory types of arthritis. At present, there are no conclusive biomarkers for the progression of OA, however, physicians believe that specific biomarkers for OA would be very useful for accurately predicting the progression or regression of the disease and may also serve as surrogate endpoints in clinical trials of disease-modifying agents.

A Compelling Demand for New Therapies

Therapeutic care of OA is primarily palliative, and the number of safe and effective treatments is very limited. There is a compelling need for disease modifying OA therapies, as currently none are available. Additionally, there is a need for safe, effective OA pain relievers, particularly in light of the concerns over the cardiovascular and gastrointestinal risks associated with COX-2 inhibitors and oral NSAIDs, and the recent market withdrawls of rofecoxib and valdecoxib.

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