Monoclonal antibodies for the treatment of osteoarthritis

ABSTRACT

Introduction: Osteoarthritis (OA) is a multifactorial chronic joint disease, and so far, there are no approved disease-modifying anti-OA drugs (DMOADs). There is an urgent need to develop therapies for different phenotypes of OA. Monoclonal antibodies (mAb) may slow structural progression, control inflammation and relieve pain, and thus have the potential to be DMOADs.

Areas covered: In this review, the authors searched the literature on PubMed, EMBASE and the Cochrane Library using keywords, including mAbs, biological agents, OA and osteoarthritis, electronically up to May 2016. They also included abstracts of international conferences. Furthermore, they reviewed experimental and clinical studies of various mAbs targeting different pathological mechanisms of OA, including ADAMTS, Interleukine-1, tumour necrosis factor, never growth factor and vascular endothelial growth factor.

Expert opinion: MAbs for the treatment of OA are under intense investigation and the results for some mAbs (e.g., anti-nerve growth factor mAbs, anti- vascular endothelial growth factor mAbs) are promising. The authors believe that mAb therapy can be a targeted therapeutic approach for the treatment of OA. Future clinical trials are required to evaluate the therapeutic efficacy of these agents by the appropriate selection of specific phenotype for targeted therapy based on the mechanism of drug action.

KEYWORDS:

• Inflammation
• OA
• DMOADs
• mAbs

Article highlights

• OA is a multifactorial chronic joint disease with different phenotypes. There is an urgent need to develop therapies targeting at different phenotypes of OA.

• Anti-ADAMTS mAbs have beneficial effects on disease progression of OA in the animal model; however, the safety and tolerability need to be investigated intensively before continuing to clinical trials in humans.

• Anti-IL-1 mAbs and anti-TNF mAbs may reduce joint pain and disease progression in patients with inflammatory hand or knee OA.

• Anti-NGF mAbs relieve OA pain very effectively. The neurosensory side effects could be a concern, but most of them would resolve after the end of treatment.

• Anti-VEGF mAbs have anti-angiogenesis effects and are promising for the treatment of post-traumatic OA phenotype.

• MAbs have the potential to be DMAODs for specific OA phenotype treatment, which would significantly delay the need for total joint replacement and other knee surgery.

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Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Additional information

Funding

This manuscript has not been funded.