Most DMOAD development strategies at the present time prefer demonstration of efficacy for the treatment of signs and symptoms before longer (2 year) structure-modification studies are initiated for FDA (Food and Drug Administration, Rockville, Maryland) approval as a DMOAD.
Thus, we need to view OA as a disease of the entire joint as we apply our various potential biomarker techniques to identify those patients at risk for accelerated progression, and to ensure better success in clinical trials of emerging DMOAD candidates.
The results of such studies should improve treatment strategies and facilitate clinical studies of future DMOADs, which depend upon enrollment of a sufficient number of disease "progressors.
Overall, the development of sensitive and specific biomarkers can guide patient selection, reduce the number needed to treat, and strengthen the power of DMOAD studies, while also indicating efficacy of response.
Bisphosphonates have surfaced as a potential DMOAD because of their ability to suppress bone turnover.
Therapeutic Strategies for DMOAD Development (Table 2)
Some have already shown positive effects on the progression of hip or knee OA, and recent studies, particularly those using new quantitative MRI technology, have provided interesting information on the planning and conducting of DMOAD trials.
Most interest in DMOAD development has focused on molecular events within articular cartilage (Fig.
Unfortunately, a candidate DMOAD that does not have intrinsic analgesic properties (e.
The present study assessed pain behavior in an experimental model of OA, using a drug that has been studied as a potential pharmaceutical to be included in the class of DMOADs