Pharmacodynamics, efficacy, safety and administration of intra-articular therapies for knee osteoarthritis.
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.
['Oo|Win Min|WM|', 'Liu|Xiaoqian|X|', 'Hunter|David J|DJ|']
D000368:Aged D018501:Antirheumatic Agents D000076722:Drug Development D005938:Glucocorticoids D006801:Humans D006820:Hyaluronic Acid D007270:Injections, Intra-Articular D020370:Osteoarthritis, Knee
increased bioavailability less systemic exposure reduced adverse events Corticosteroids hyaluronic acid intra-articular injection