Arthritis foundation



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(top of page) Future Directions The development of selective COX-2 inhibitors has been an exciting advance in the management of pain and inflammation, as discussed above. arthritis foundation Arthritis foundation. If the safety profile of the specific COX-2 inhibitors is confirmed in additional long-term studies to be superior to non-selective COX inhibitors, they are likely to replace traditional NSAIDs in the management of arthritis and other painful, inflammatory conditions. It should be kept in mind, however, that no matter what their degree of selectivity, COX inhibitors (NSAIDs) do not alter the natural history of OA and a "disease modifying" agent is still critically needed. arthritis foundation One disease modifying strategy is to suppress the progressive degradation of cartilage that occurs in OA. Leg burning pain. To accomplish this, the ratio of MMP inhibitors to MMP enzymes must be shifted in favor of the former. This could be accomplished by enhancing articular levels of TIMP by recombinant gene therapy or by administration of exogenous TIMP. Studies of exogenous TIMP administration to animals with OA-like disease have had inconclusive results, however, perhaps due to ineffective penetration of this relatively high molecular weight protein into the cartilage matrix. foundation arthritis Pain. An alternate approach , that has progressed more rapidly, is to develop oral inhibitors of MMPs.
arthritis foundation
In fact, several synthetic small molecular weight inhibitors of MMPs have proven efficacious in animal models of arthritis and are entering Phase III clinical trials in humans. The antibiotic, tetracycline, and its semisynthetic derivatives, doxycycline and minocycline, have modest MMP inhibitory properties and have prompted investigations of these agents in the treatment of both OA and RA. Finally, inhibition of IL-1, via administration of a soluble IL-1 receptor or receptor antagonist, represents another rational strategy for suppressing MMP synthesis, and preliminary studies in RA are also promising.

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Arthritis foundation



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