Osteoarthritis research: Can doctors slow or reverse joint damage?

As you cope with osteoarthritis, researchers are working to better understand what causes osteoarthritis and how to slow or stop associated joint damage. There's still no cure. But new drugs are being developed.

Beyond pain relief: Researchers hope to stop joint damage

While current medications can relieve your pain and improve your joint mobility, they can't stop osteoarthritis from progressing and further damaging your joints. Researchers hope they can change that. Experiments and investigations into new drugs that could slow, stop or even reverse joint damage are under way. Areas of investigation include:

Antibiotics
Antibiotics are traditionally used to fight infections. It's now known that certain antibiotics can also decrease inflammation inside your affected joints. Antibiotics also block the proteins that play a role in the breakdown of the cartilage in your joints. Early studies of the antibiotic doxycycline have shown promise in osteoarthritis treatment, though more research is needed.

Drugs that interfere with inflammatory signals
Proteins called cytokines send signals to cells to cause inflammation in your joints. The inflammation plays a role in joint damage. By blocking or stopping these cytokines, researchers hope they can slow or stop joint damage. Osteoarthritis isn't typically thought of as an inflammatory disease, but researchers have found that people with osteoarthritis have higher levels of inflammatory cells in their joints than are found in the joints of people who don't have osteoarthritis.

Treatments aimed at an inflammatory cytokine called interleukin-1 (IL-1) include:

• A rheumatoid arthritis treatment. Anakinra (Kineret) blocks the receptors that decode the inflammation-causing signals sent by IL-1. By blocking the receptors, anakinra stops the messages from getting through. Doctors use anakinra to treat rheumatoid arthritis, since people with that condition also have an overabundance of IL-1 in their joints. Researchers are testing whether injecting anakinra into a joint can prevent damage from osteoarthritis.
• A treatment that uses your own blood. A treatment used in some European countries uses a sample of your own blood to create a medication to block IL-1 receptors. The treatment, marketed under the name Orthokine, is then injected into your affected joint. While a promising theory, this treatment hasn't been carefully studied, and it still isn't clear whether it can prevent joint damage.
• A drug that blocks one part of IL-1. A new drug being tested in osteoarthritis blocks a specific part of IL-1. Researchers have found the drug, diacerein, may control osteoarthritis pain, but more study is needed to determine if it can stop joint damage.

Gene therapy
Researchers hope that targeting certain genes in your body might influence cells in your joints to reduce inflammation and joint damage. One way to do this might be to block the action of damaging genes. Another way might be to replace the damaging genes with genes that would reverse joint damage. One roadblock to gene therapy is finding a way to deliver the genes to the body. Study of gene therapy for osteoarthritis is still in the very early stages, though some animal research has shown promise.

Drug development and approval: Long waits, no guarantees

It takes many years to develop new drugs. Beyond proving they work, researchers must prove they're safe for people to use. It's encouraging to look ahead to treatments that may one day make treating osteoarthritis safer and more efficient. But some of these experimental drugs could take years to win approval, and others may never make it to the market. In the meantime, talk with your doctor about what you can do to make the most of the treatments available to you now.

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