New developments in the management of osteoarthritis

Osteoarthritis (OA) is the most common form of arthritis and a leading cause of pain, disability, and healthcare utilization worldwide, responsible for a substantial clinical and socioeconomic burden on society. Currently available and approved therapies remain predominantly symptom-directed, as clinical trials have failed to demonstrate efficacy of any disease-modifying approach that could halt OA progression. However, advances in the understanding of OA pathogenesis have led to the emergence of therapeutic strategies targeting metabolic dysfunction, inflammation, tissue repair, and pain pathways. The present review highlights recent developments in OA management including repurposed metabolic and anti-rheumatic therapies, regenerative approaches such as platelet-rich plasma (PRP) and mesenchymal stem cells, minimally invasive interventional procedures, and emerging biologic and gene therapies. The increased recognition of distinct OA phenotypes has led to the opportunity to translate these discoveries into precision medicine approaches. Still, significant challenges remain in identifying appropriate patient populations and generating the high-quality evidence necessary to bring disease-modifying therapies into clinical practice.