Disease Modifying Osteoarthritis Drugs - The Search for the 'Holy Grail' Continues

Scope and coverage

• The lack of accuracy and reproducibility of radiography as the method of end-point assessment has created difficulties for clinical trials.
• Research into biomarkers offers a possible solution to both end-point assessment and earlier diagnosis.
• Doxycycline, Amgen's Kineret and a MMP Inhibitor from P&G offer the most promising DMOAD prospects in the pipeline.
• Success in this area will depend heavily of clinical trial design, dosing regimes and formulation properties of the drug.

Key findings and highlights

• Research is predominantly at an early discovery or pre-clinical stage, with only three products in human trials. P&Gs MMP inhibitor, although at an early stage, has shown promising results in a well-designed trial. Tissue engineering also has great potential as a disease modifying approach, Biosyntech currently have a product, BST-Cargel, in PI.
• The main issues dominating DMOAD research are, elucidation of the precise mechanism and pathways involved in OA, and selection of the most effective drug delivery approach. Delivery of the drug to the affected joint in a sufficient concentration, without adversely affecting the rest of the body, is proving problematic.
• The gold standard radiographic method of measuring trial outcome can lack clinical relevance and rarely produces consistently accurate measurements. Symptomatic outcome measurements are subjective and can be influenced by treatments that do not alter the cartilage such as commonly used analgesics and NSAIDs.

Reasons to purchase

• Understand the current research
• Compare DMOADs in the pipeline
• Identify the drivers and constraints in DMOAD research