Pharmacological osteoarthritis therapy and modern therapeutic principles

Abstract

Introduction. The purpose of treating osteoarthritis is to relieve pain, improve the function of the osteoarthritic joint, and arrest further development of osteoarthritis through non-pharmacological and pharmacological treatment modalities. Pharmacological osteoarthritis therapy. In the treatment of osteoarthritis, guidelines and recommendations are often consulted, but they do not dictate the treatment mode, which is tailored to the individual needs of the patient. These guidelines promote desired and positive treatment outcomes, but cannot predict a specific outcome. They are also valuable when analyzing the use of topical and oral non-steroidal anti-inflammatory drugs, keeping dosage as low as possible for the shortest time. For example, monitoring hepatotoxicity is advised when administering paracetamol, while caution is needed when prescribing drugs with a central effect due to the possible development of addiction and appearance of toxic effects. A significant body of research on the use of chondroprotectors exists, but there is a large discrepancy across studies. Nonetheless, their findings indicate benefits of intra-articular administration of glucocorticoids. However, their more frequent administration can lead to accelerated cartilage loss, while guidelines differ concerning intra-articular administration of hyaluronic acid, the administration of plasma enriched with platelets, and the administration of stem cells due to the heterogeneity of the preparations and the lack of standardization in their administration. Conclusion. Non-surgical therapy is a growing field of research, especially from a pharmacological point of view, intending to find the best treatment to slow down or completely stop further development of osteoarthritis.