10.4 Flashcards
(10 cards)
- How is OA treatment approached in terms of structural pathology versus symptoms?
Current OA management divides treatment into addressing structural joint damage (though no approved disease–modifying drugs exist) and relieving symptoms like pain and disability.
- What are the key non-pharmacological treatments currently recommended for OA?
These include patient education, weight management, exercise (land-based and strength training), and self-management to improve function and reduce pain.
- What pharmacological treatments are used in OA management and what do they target?
Pharmacologic therapies—such as NSAIDs, paracetamol, and intra-articular corticosteroid or hyaluronic acid injections—primarily target pain and inflammation rather than reversing structural damage.
- What surgical options are available for severe OA?
Joint replacement (arthroplasty) is the main surgical intervention, though it is usually reserved for advanced disease after conservative treatments have failed.
- Why is there a gap in treatments that modify OA structure?
Current therapies focus on symptomatic relief because OA is a multifaceted, multi-tissue disease, and there are no approved drugs that reliably halt or reverse the underlying structural degeneration.
- What is the biological rationale behind developing future OA therapeutics?
Emerging treatments aim to target the underlying mechanobiological pathways that drive cartilage breakdown, synovial inflammation, and subchondral bone changes—often guided by OA phenotypes and specific biomarkers.
- How do mechanical and biological risk factors interact in OA pathogenesis?
Excessive loading, joint instability, adipokine secretion, and systemic inflammation all contribute to progressive tissue damage through complex cross-talk among cartilage, bone, and synovium.
- What are OA phenotypes and endotypes, and why are they important?
OA phenotypes are distinct subtypes based on variations in tissue involvement (e.g., cartilage-driven, synovitis-driven, bone-driven) that can guide personalized and targeted therapeutic strategies.
- How might biomarkers aid in developing new OA treatments?
Biomarkers help identify patient-specific disease endotypes, allowing clinicians to tailor interventions that target the active pathways driving degeneration and pain.
- What future directions are anticipated in OA management?
The field is moving toward multifaceted, phenotype-targeted therapies that address both structural changes and pain mechanisms, alongside improved risk factor modification and novel drug development.
