Therapeutic options for targeting inflammatory osteoarthritis pain

Pain is the major symptom of osteoarthritis (OA) and is an important factor in strategies to manage this disease. However, the current standard-of-care does not provide satisfactory pain relief for many patients. The pathophysiology of OA is complex and its presentation as a clinical syndrome is associated with pathologies of multiple joint tissues. Inflammation is associated with both OA pain and disease outcome and is therefore a major target to treat OA and OA pain. Unlike TNF inhibitors and IL-1 inhibitors, established drugs such as corticosteroids and methotrexate can reduce OA pain. Although central nociceptive pathways contribute to OA pain, crosstalk between the immune and nociceptive neurons is central to inflammatory pain; therefore, new therapies might target this crosstalk. Indeed, newly identified drug targets including neurotrophins and the GM-CSF-CCL17 axis offer the hope of better results, but require clinical validation.