EDITORIALS
Bisphosphonates for osteoarthritis prevention: "Holy Grail" or not?
Center for Education and Research on Therapeutics (CERTs) of Musculoskeletal Disorders, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama, USA
Correspondence to:
Kenneth G Saag, Center for Education and Research on Therapeutics (CERTs) of Musculoskeletal Disorders, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, 820 Faculty Office Tower, 510 20th Street South, Birmingham, Alabama 35294-3708, USA; Kenneth.Saag@ccc.uab.edu
Accepted 13 July 2008
| The first 150 words of the full text of this article appear below. |
The search for effective disease modifying osteoarthritis (OA) agents has been a long and winding road with much unrealised promise. While a debate persists about whether OA is predominately a disease of bone, cartilage, or both, there has been interest in the possible OA disease modifying effects of bone antiresorptive agents including oestrogens, selective oestrogen receptor modulators, calcitonin and bisphosphonates.1 Bisphosphonates, the most commonly used therapeutic agents for osteoporosis prevention and treatment, hold OA treatment appeal based on their known pharmacology of altering bone remodelling through a direct inhibitory effect on the osteoclast. Such effects could retard subchondral bone remodelling, believed important by some in osteophyte formation and subchondral sclerosis. Also of potential benefit in OA, bisphosphonates have effects beyond the osteoclast and may be slightly immunomodulating via inhibition of pro-inflammatory cytokines.2 In vitro, etidronate binds to human cartilage3 and can modestly inhibit matrix metalloproteinases.4 Neridronate stimulated osteoblasts to produce
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