Developing anti-inflammatory therapeutics for patients with osteoarthritis

Osteoarthritis (OA) is the most common joint disorder in the world but there are no 27 approved therapeutics to prevent disease progression. Historically, OA has been 28 considered a wear and tear joint disease and efforts to identify and develop disease 29 modifying therapeutics have predominantly focussed on direct inhibition of cartilage 30 degeneration. However, there is now increasing evidence that inflammation is a key 31 mediator of OA joint pathology and also that the link between obesity and OA is not 32 solely due to excessive load-bearing, suggesting therefore that targeting 33 inflammation in OA could be a rewarding therapeutic strategy. In this review we 34 therefore re-evaluate historical clinical trial data on anti-inflammatory therapeutics in 35 OA patients, highlight some of the more promising emerging therapeutic targets and 36 discuss the implications for future clinical trial design.