Disease Modification in Rheumatoid Arthritis and Osteoarthritis-Current and Emerging Targets and Therapeutics

The population effected by rheumatoid arthritis (RA) and osteoarthritis (OA) is increasing worldwide. There is also a dramatic progress in the understanding of the etiology and pathophysiology of these diseases and the use of biological disease modifying anti-rheumatic drugs (DMARD) for the treatment of RA. High costs of biological DMARDs and the lack of oral drugs are the biggest limitations to RA therapy. In addition, there are currently no orally bioavailable disease-modifying OA drugs (DMOADs) in market. While inflammation continues to be the primary target for drug discovery in RA, inhibiting degradative pathways and promoting anabolic pathways may have potential in OA. Synthetic disease modifying agents with better efficacy, lesser side effects and affordability to use in a chronic disease is the unmet pharmacological need. The present review summarizes the key molecular pathways contributing to the disease and emerging drugs that prevent these pathways.