I had mentioned it in a recent previous post briefly:
----- Posted 30th Aug 2022
Chels, JamesT is quite right...but I have heard a few of these in the past too, the below is my brief viewpoint:
Lets take a quick look at each of them one by one:
MMP INHIBITORS
Single target inhibitors are riddled with side effects and potential adverse reactions. We have many examples of these. You need a holistic approach for a holistic disease. There are mixed results but certainly there are warnings and trials that have been halted...
One example; "The most frequent side-effect observed in clinical trials of MMP inhibitors was the development of the MSS that manifested as pain and immobility in the shoulder joints, arthralgias and contractures in the hands".1
(MSS = musculoskeletal syndrome)
BIOPHOSPHONATES
I had come across this while ago, it featured in one of the broker reports (might have been Lodge Partners?)...there is some evidence that it is not harmful and can have some improvement in addressing BME's. More trials need to be set up here to really investigate it. One comment about it from a paper:
"There is limited evidence that bisphosphonates are effective in the treatment of OA pain".2
CALCITONIN
The same paper suggests that Calcitonin. "...did not exert significant and/or symptomatic benefit in the general OA population".
See discussion above for MMP - single targeted. Most likely it isn't going to be successful. specially in a larger cohort/segment of population.
iNOS INHIBITORS
Single targeting yet again...results so far?
"However, the compound did not improve JSN, joint pain or function. No further attempts have bene made to develop iNOS inhibitors as a therapeutic option for OA".
DOXYCLINE
Not great results here so far..."...that the symptomatic benefit of doxycycline is minimal to non-existent, while the small benefit it terms of JSN is of questionable clinical relevance and outweighed by safety problems".
STRONTIUM
Its more for osteoporosis tough there are some beneficial effects on radiographical progression of OA. While it does show some DMOAD properties, according to the same article, "However, it is debatable whether the data, beyond being statistically significant, were also clinically meaningful".
CATHESPIN K INHIBITORS
Yet another specific inhibitor...
"While reversible thickening morphea-like skin changes were reported in nine patients, the full data have never been reported, aside from one presentation at a European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) conference in which MRI data did not show structural progression".
ESTROGEN
Could possibly show some benefit here. "A Women's Health Institute study documented that women taking unopposed estrogen had significantly lower rates of hip, but not knee, total joint replacement (TJR) surgery".
But there is also conflicting evidence, "Conversely, estrogen seems to have no protective or even damaging effect on OA on some other studies".3
SPRIFERMIN
This one we have discussed recently, there may be some evidence that it can address cartilage thickness but in one arthritis research paper it was found "...intra-articular sprifermin did not likely have any positive effect on symptom alleviation".3
Don't think I'm just discounting everything. There are many types of variants in the above categories and one day something may strike that's safe and efficacious and might pose some competition for us. Think it is mainly a number of years away and add to that clinical trials which is a long process (We kinda know about that eh'?). But keep an eye open for the competition. The market is large/huge...but still need to be wary.
(20min delay)