Impact of Symptomatic Slow-Acting Drugs on Inflammatory Pathways in Osteoarthritis: Therapeutic Advances and Future...

Area of Science:

• Orthopedics and Rheumatology
• Pharmacology
• Biochemistry

Background:

• Osteoarthritis (OA) is a major cause of disability and economic burden, with current treatments primarily managing symptoms.
• Disease-modifying therapies are urgently needed as OA progression is largely uncontrolled.
• Symptomatic slow-acting drugs for osteoarthritis (SYSADOAs), including glucosamine (GlcN), chondroitin sulfate (CS), and hyaluronic acid (HA), are gaining attention.

Purpose of the Study:

• To critically evaluate the current evidence on the safety, mechanisms of action, and therapeutic potential of HA, GlcN, and CS for OA.
• To explore their role in modifying the natural course of knee, hand, and hip OA.
• To address the ongoing debates regarding their long-term efficacy and safety.

Main Methods:

• Systematic review of existing scientific literature.
• Analysis of studies investigating the homeostatic, anti-inflammatory, antioxidant, antiapoptotic, and anabolic effects of HA, GlcN, and CS.
• Evaluation of clinical trial data on the efficacy and safety of these SYSADOAs.

Main Results:

• HA, GlcN, and CS modulate key homeostatic mechanisms involved in OA.
• These compounds demonstrate anti-inflammatory, antioxidant, antiapoptotic, and anabolic effects.
• Evidence regarding their long-term efficacy and safety remains debated, leading to varied recommendations.

Conclusions:

• HA, GlcN, and CS hold promise as disease-modifying agents for OA.
• Further research is needed to clarify their long-term benefits and establish consistent treatment guidelines.
• These SYSADOAs offer potential therapeutic perspectives for managing knee, hand, and hip OA progression.