Because a majority of clinical trials exploring new treatment options for osteoarthritis have produced negative results, rheumatologists continue to push lifestyle changes as first-line treatments for pain in patients with the disease and consider a slew of subsequent treatments, according to a report from Healio. In order to manage osteoarthritis, experts recommended eating a healthy diet; following regular exercise regimens such as yoga and tai chi; undergoing physical therapy; and avoiding experimental treatments such as transcutaneous electric nerve stimulation, chondroitin, platelet-rich plasma injections, and stem cell injections. The experts underscored that weight loss may be an important factor in reducing disease burden; however, encouraging patients to be more active has been challenging. Experts stressed the significance of understanding that osteoarthritis does not just result in structural changes to patients’ joints, but also limits joint functionality and increases pain without the promise of a cure—which can take a toll on the patients’ mental well-being.
Rheumatologists were advised to help patients reduce their pain and educate them about common exercise misconceptions as a means of promoting a more active lifestyle. For patients who need more coaxing, wearable devices may influence positive behavioral changes in their exercise routines and help motivate them to maintain regular levels of activity. Additionally, patients with advanced osteoarthritis may undergo joint replacement surgery—which has seen recent improvements in technology, methodology, and durability—though patients and their physicians should discuss the benefits and potential risks of this type of procedure. Regarding therapeutic options, new methods of targeting pain and inflammation—such as the inhibition of inflammatory cytokines, introduction of anti-inflammatory molecules, and reduction of senolytic cells in the joints—are currently in early phases of study and may prove effective in the future. The experts concluded that while other novel agents such as lorecivivint, sprifermin, and canakinumab have demonstrated mixed results, larger studies will be needed to assess the full clinical benefits and their promise as new treatments for patients with osteoarthritis. The experts recommended that patients discuss all treatment options with a rheumatologist prior to use.