Pharmacodynamics, efficacy, safety and administration of intra-articular therapies for knee osteoarthritis. (2nd December 2019)

• Record Type: Journal Article
• Authors: Oo, Win Min; Liu, Xiaoqian; Hunter, David J.
• Is Part Of: Expert opinion on drug metabolism and toxicology. Volume 15:Number 12(2019)
• Page Start: 1021
• Page End: 1032
• Publication Date: 2019-12-02
• Subjects: Corticosteroids -- hyaluronic acid -- intra-articular injection -- increased bioavailability -- less systemic exposure -- reduced adverse events; Drugs -- Toxicology -- Periodicals; Drugs -- Metabolism -- Periodicals; 615.7
• DOI: 10.1080/17425255.2019.1691997
• Languages: English
• ISSNs: 1742-5255

Abstract

ABSTRACT: Introduction : Osteoarthritis (OA) is the leading cause of disability in the elderly, usually presenting with mono-or oligo-arthritis where local drug delivery by intra-articular (IA) injection may be more effective in terms of increased bioavailability, less systemic exposure and reduced adverse events. Several intra-articular medications for symptomatic are available on the market while the new disease-modifying drugs (DMOADs) are progressing into phase 3 pipeline of drug development. Areas covered : This narrative review covered the pharmacokinetic and pharmacodynamics of clinically available IA drugs which include corticosteroids, hyaluronic acid as well as injection techniques, efficacy, adverse effects and contraindications. In addition, the authors briefly describe the newer disease-modifying OA drugs (DMOAD) which are undergoing phase 3 pipeline of development such as Fibroblast growth factor (FGF-18) and Wnt inhibitor. Expert opinion : This is a rapidly evolving area with both new products and new trials regularly emerging. It is also a critically important area in a disease field that lacks for safe and effective treatments, where intra-articular delivery may enhance both local efficacy and reduce systemic toxicity.