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Journal of Rheumatic Diseases and Treatment





DOI: 10.23937/2469-5726/1510001



Subchondral Bone: An Emerging Target for Treatment of Osteoarthritis

Lukas A Holzer*


Department of Orthopaedic Surgery, Medical University of Graz, Austria


*Corresponding author: Lukas A Holzer, MD, Department of Orthopaedic Surgery, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz, Austria, Email: lukas.holzer@medunigraz.at
J Rheum Dis Treat, JRDT-1-001, (Volume 1, Issue 1), Editorial; ISSN: 2469-5726
Received: February 10, 2015 | Accepted: February 12, 2015 | Published: February 15, 2015
Citation: Holzer LA (2015) Subchondral Bone: An Emerging Target for Treatment of Osteoarthritis. J Rheum Dis Treat 1:001e. 10.23937/2469-5726/1510001
Copyright: © 2015 Holzer LA. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.



OA is a long-term chronic disease that is characterized by the deterioration of cartilage in joints resulting in stiffness, pain and impaired range of motion. OA is a disease that is associated with ageing. However, there are various factors e.g. obesity, lack of exercise, genetical abberations, occupation, trauma and gender that contribute to progression of OA [1].

Osteoarthritis (OA) is the most common form of arthritis [1,2]. The World Health Organization estimates that globally 25% of adults over the age of 65 years have clinically symptomatic osteoarthritis of any joint [2]. It ranks fourth in health impact in women and eighth in men in the civilized western world. OA ranks second only to cardiovascular disease as a cause of disability (e.g. walking or stair climbing) [1,2]. OA affects patients and health care systems worldwide. Due to the socio-demographic changes in the civilized western world preventive measures are becoming increasingly important [2].

In recent years the role of subchondral bone in the progression of OA has been studied intensively. It seems that subchondral bone and cartilage are a functional unit in which structural changes in one tissue will affect the other and vice versa. Therefore the subchondral bone might be a potential target for future treatment of osteoarthritis [3].

A disease-modifying osteoarthritis drugs slows the progression of OA and improves symptoms and/or function [4]. This group of drugs includes agents that are commonly used for the treatment of osteoporosis such as antiresorptive drugs (estrogens, SERMs and bisphosphonates), anabolic drugs (such as parathormone/teriparatide) or drugs with a dual mechanism (strontium ranelate) [4]. Of these medications especially strontium ranelate and bisphosphonates showed promising results on OA progression and subchondral bone changes in experimental and clinical settings [5].


References
  1. Hunter DJ, Felson DT (2006) Osteoarthritis.BMJ 332: 639-642.

  2. Johnson VL, Hunter DJ (2014) The epidemiology of osteoarthritis. Best Pract Res Clin Rheumatol 28: 5-15.

  3. Burr DB, Gallant MA (2012) Bone remodelling in osteoarthritis. Nat Rev Rheumatol 8: 665-673.

  4. Qvist P, Bay-Jensen AC, Christiansen C, Dam EB, Pastoureau P, et al. (2008) The disease modifying osteoarthritis drug (DMOAD): Is it in the horizon? Pharmacol Res 58: 1-7.

  5. Castaneda S, Roman-Blas JA, Largo R, Herrero-Beaumont G (2012) Subchondral bone as a key target for osteoarthritis treatment. Biochem Pharmacol 83: 315-323.

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