Friday, January 27, 2006

Osteoarthritis is a degenerative joint disease occurring mainly in the elderly. It is the most common form of arthritis and according to our feature Disease Modifying Osteoarthritis Drugs - The Search for the 'Holy Grail' Continues this debilitative condition affects over 73 million people in the seven major pharmaceutical markets. Disease modification is currently the ‘holy grail’ in the treatment of osteoarthritis, driven by an aging population and recent success of disease modifiers for rheumatoid arthritis.

One of the major hurdles in reaching this goal is gaining an understanding of the precise mechanism and pathways involved in osteoarthritis. Today’s headline article from DailyUpdates, published in a recent edition of Scand J Rheumatol highlights the involvement of nitric oxide (NO) in osteoarthritis and moreover suggests that disease-modifying anti-rheumatic drugs (DMARDS) developed for the treatment of rheumatoid arthritis may be effective in the treatment of osteoarthritis through the reduction of NO levels.

Although key to a number of physiological processes, excessive NO has been implicated in numerous diseases. Important therapeutic areas for NO-based therapies are inflammatory disorders, cardiovascular diseases, erectile dysfunction, inflammation, pain and neuroprotection. The first therapeutic use of NO was by inhalation for acute respiratory distress syndrome (ARDS).

In the worldwide pharmaceutical market, share of drugs where NO is involved in the mechanism of action is now estimated at $20 billion and is projected to rise to $34.1 billion in 2010 and $52 billion in 2015 as new drugs with NO-based mechanisms are introduced into the market (see Nitric Oxide - Therapeutics, Markets and Companies).
NO is known to be a destructive mediator produced by activated chondrocytes and in their Scand J Rheumatol article, Eeva Moilanen and colleagues reported that four known DMARDs suppressed the production of NO under these conditions. This effect was extended to a reduction in NO production in cartilage from patients with osteoarthritis. This study suggests that therapeutic agents historically used for the treatment of rheumatoid arthritis should also be investigated as treatments of osteoarthritis.


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