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Osteoarthritis (OA) is the most common musculoskeletal disorder and its prevalence is increasing.1 Non-surgical treatments are often frustratingly ineffective and while some medical treatments are modestly efficacious, none are approved that delay the course of disease. The failure of medical treatments for OA of both the hip and the knee is a primary underlying reason for the rapidly increasing rates of knee and hip replacements in developed countries. New efficacious therapies that might alleviate pain or delay the structural progression of this disease are badly needed.
One promising major approach for treatment of OA is abrogation of the inflammatory response within the joint. Increasingly, OA is regarded as an inflammatory disease2 even though the degree of inflammation varies and is often modest. MRI studies have shown that the synovitis that commonly accompanies disease in the knees and hands contributes to disease progression, including cartilage loss. MRI-based studies have shown that synovitis is likely to be a major cause of joint pain. In fact, at least two of the known efficacious treatments for OA target inflammation within the joint: non-steroidal anti-inflammatory drugs and intra-articular corticosteroids. The latter are highly effective in relieving joint pain over a short …