A Promising Treatment for Osteoarthritis?
Authors: Nancy Lane, David Felson
Journal: Annals of Internal Medicine (2020)

Editorials6 October 2020A Promising Treatment for Osteoarthritis?Nancy Lane, MD and David Felson, MD, MPHNancy Lane, MDUC Davis Health, Sacramento, California (N.L.) and David Felson, MD, MPHBoston University School of Medicine, Boston, Massachusetts (D.F.)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/M20-4938 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Osteoarthritis, the most common type of arthritis, increases in prevalence with age and is a leading cause of joint pain and disability worldwide (1). Currently, no treatments exist that can either prevent or slow progression of the disease. Osteoarthritis is characterized by loss of articular cartilage, bone remodeling, and synovial inflammation. Studies suggest that both inflammation and abnormal joint loading trigger local release of inflammatory cytokines, including interleukin-1β (IL-1β), IL-6, and tumor necrosis factor. These inflammatory cytokines alter the chromatin landscape and activate the genes that transcribe proteins catabolically to cartilage and bone, including matrix metalloproteinases, ADAMTS5, and MAP kinases. ...References1. Neogi T. The epidemiology and impact of pain in osteoarthritis. Osteoarthritis Cartilage. 2013;21:1145-53. [PMID: 23973124] doi:10.1016/j.joca.2013.03.018 CrossrefMedlineGoogle Scholar2. Vincent TL. IL-1 in osteoarthritis: time for a critical review of the literature. F1000Res. 2019;8. [PMID: 31249675] doi:10.12688/f1000research.18831.1 CrossrefMedlineGoogle Scholar3. Jin X, Beguerie JR, Zhang W, et al. Circulating C reactive protein in osteoarthritis: a systematic review and meta-analysis. Ann Rheum Dis. 2015;74:703-10. [PMID: 24363360] doi:10.1136/annrheumdis-2013-204494 CrossrefMedlineGoogle Scholar4. Pearle AD, Scanzello CR, George S, et al. Elevated high-sensitivity C-reactive protein levels are associated with local inflammatory findings in patients with osteoarthritis. Osteoarthritis Cartilage. 2007;15:516-23. [PMID: 17157039] CrossrefMedlineGoogle Scholar5. Chevalier X, Goupille P, Beaulieu AD, et al. Intraarticular injection of anakinra in osteoarthritis of the knee: a multicenter, randomized, double-blind, placebo-controlled study. Arthritis Rheum. 2009;61:344-52. [PMID: 19248129] doi:10.1002/art.24096 CrossrefMedlineGoogle Scholar6. Fleischmann RM, Bliddal H, Blanco FJ, et al. A phase II trial of lutikizumab, an anti-interleukin-1α/β dual variable domain immunoglobulin, in knee osteoarthritis patients with synovitis. Arthritis Rheumatol. 2019;71:1056-1069. [PMID: 30653843] doi:10.1002/art.40840 CrossrefMedlineGoogle Scholar7. Cohen SB, Proudman S, Kivitz AJ, et al. A randomized, double-blind study of AMG 108 (a fully human monoclonal antibody to IL-1R1) in patients with osteoarthritis of the knee. Arthritis Res Ther. 2011;13:R125. [PMID: 21801403] doi:10.1186/ar3430 CrossrefMedlineGoogle Scholar8. U.S. National Library of Medicine. To Determine the Safety, Tolerability, Pharmacokinetics and Effect on Pain of a Single Intra-articular Administration of Canakinumab in Patients With Osteoarthritis in the Knee. Accessed at https://clinicaltrials.gov/ct2/show/NCT01160822 on 29 June 2020. Google Scholar9. Ridker PM, Everett BM, Thuren T, et al; CANTOS Trial Group. Antiinflammatory therapy with canakinumab for atherosclerotic disease. N Engl J Med. 2017;377:1119-1131. [PMID: 28845751] doi:10.1056/NEJMoa1707914 CrossrefMedlineGoogle Scholar10. Schieker M, Conaghan PG, Mindeholm L, et al. Effects of interleukin-1β inhibition on incident hip and knee replacement. Exploratory analyses from a randomized, double-blind, placebo-controlled trial. Ann Intern Med. 2020;173:509-15. [PMID: 32744862]. doi:10.7326/M20-0527 LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: UC Davis Health, Sacramento, California (N.L.)Boston University School of Medicine, Boston, Massachusetts (D.F.)Grant Support: By National Institutes of Health grants AR072571 and P50AR063043.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M20-4938.Corresponding Author: Nancy Lane, MD, Department of Internal Medicine and Division of Rheumatology, UC Davis Health, 4625 Second Avenue, Sacramento, CA 95817; e-mail, [email protected]edu.Current Author Addresses: Dr. Lane: Department of Internal Medicine and Division of Rheumatology, UC Davis Health, 4625 Second Avenue, Sacramento, CA 95817.Dr. Felson: Evans Biomedical Research Center, 650 Albany Street, Boston, MA 02118.This article was published at Annals.org on 4 August 2020. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoEffects of Interleukin-1β Inhibition on Incident Hip and Knee Replacement Matthias Schieker , Philip G. Conaghan , Linda Mindeholm , Jens Praestgaard , Daniel H. Solomon , Celeste Scotti , Herman Gram , Tom Thuren , Ronenn Roubenoff , and Paul M Ridker Metrics Cited bySynovial inflammation in osteoarthritis progression 6 October 2020Volume 173, Issue 7Page: 580-581KeywordsArthralgiaC-reactive proteinsCartilageCytokinesHigh sensitivity c reactive proteinInflammationMortalityOsteoarthritisTotal hip replacementTotal knee replacement ePublished: 4 August 2020 Issue Published: 6 October 2020 Copyright & PermissionsCopyright © 2020 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...