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GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE

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Gazzetta Medica Italiana Archivio per le Scienze Mediche 2005 August;164(4):243-51

language: English

Structure modifying drugs for osteoarthritis: an update

Fioravanti A.

Institute of Rheumatology, University of Siena, Siena, Italy


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The treatment of OA is today aimed at controlling symptoms as well as at preventing or retarding progression of structural modifications involving joint tissues (cartilage, bone, synovium, ligaments and muscles). To this purpose the academia and pharmaceutical industry have developed a novel category of drugs defined in the past as chondroproptective agents which are now called Structure Modifying Drugs for OA. Several pharmacological agents are currently being studied as structure modifying drugs. These drugs range from empirical compounds to specific inhibitors of metalloproteinases or cytokines. Data currently available on many drugs are mainly experimental, whereas studies on man are still in their initial phase. Actually the better evidence of a structure modifying activity in human OA is obtained for Glucosamine sulfate, while preliminary results also suggest that other compounds, as Chondroitin sulfate, Diacerhein, Avocado/soybean Unsaponifiables and Hya-luronic acid, have a possible structural effect in OA. However, as regards the molecules currently in use, it is necessary to clarify which clinical and radiological studies should be selected for administration of a disease modifying therapy, which are its most appropriate administration modalities and schedules, which are the most effective and best tolerated drugs, and the time required for a good clinical response to be obtained.

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