Currently, no disease-modifying therapies for osteoarthritis (OA) exist, and attempts to identify novel cellular targets have been challenging. Risk factors for OA include advanced age, obesity, and metabolic syndrome. This creates an attractive opportunity to repurpose existing drugs that are used to treat comorbidities commonly encountered in patients with OA, if those drugs possess OA disease modifying properties. This narrative review incorporates findings from knee or hand OA randomized clinical trials, post-hoc clinical trial analyses, prospective cohort studies, and observational data. Drugs used for the treatment of rheumatoid arthritis (methotrexate; TNFa, IL-1, and IL-6 pathway inhibitors; hydroxychloroquine), atopic/allergic disease (anti-histamines), osteoporosis (bisphosphonates and vitamin D), type 2 diabetes (metformin and GLP-1 agonists), and cardiovascular disease (atorvastatin, fish oil, and beta blockers) were reviewed for their potential benefit in OA. This review outlines the successful attributes of repurposed drugs, the challenges in repurposing drugs, and strategies for future clinical trials to support OA drug repurposing. Potential drug candidates for OA may be identified through the use of existing datasets and via collaborations with researchers in other fields to include OA endpoints in future clinical trials. Given the association of OA with several commonly treated comorbidities, drug repurposing is an appealing approach that could provide a favorable benefit-to-risk ratio for chronic OA treatment.

中文翻译：

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重新利用治疗骨关节炎的药物


目前，还没有针对骨关节炎（OA）的疾病缓解疗法，并且尝试识别新的细胞靶点一直具有挑战性。骨关节炎的危险因素包括高龄、肥胖和代谢综合征。这创造了一个有吸引力的机会，可以重新利用现有药物来治疗 OA 患者常见的合并症，如果这些药物具有缓解 OA 疾病的特性。这篇叙述性综述纳入了膝关节或手部 OA 随机临床试验、事后临床试验分析、前瞻性队列研究和观察数据的结果。用于治疗类风湿性关节炎（甲氨蝶呤；TNFa、IL-1 和 IL-6 通路抑制剂；羟氯喹）、特应性/过敏性疾病（抗组胺药）、骨质疏松症（双膦酸盐和维生素 D）、2 型糖尿病（二甲双胍）的药物和 GLP-1 激动剂）和心血管疾病（阿托伐他汀、鱼油和 β 受体阻滞剂）对 OA 的潜在益处进行了审查。这篇综述概述了药物再利用的成功属性、药物再利用的挑战以及支持 OA 药物再利用的未来临床试验策略。可以通过使用现有数据集并通过与其他领域的研究人员合作来确定 OA 的潜在候选药物，以将 OA 终点纳入未来的临床试验。鉴于 OA 与几种常用治疗合并症的相关性，药物再利用是一种有吸引力的方法，可以为慢性 OA 治疗提供有利的获益风险比。