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Transcript of Osteoarthritis (OA): Updates on development, treatment and possible prevention Kevin Deane, MD/PhD...
![Page 1: Osteoarthritis (OA): Updates on development, treatment and possible prevention Kevin Deane, MD/PhD Associate Professor of Medicine Division of Rheumatology.](https://reader035.fdocuments.in/reader035/viewer/2022062407/56649dc85503460f94abd50e/html5/thumbnails/1.jpg)
Osteoarthritis (OA):Updates on development, treatment and
possible prevention
Kevin Deane, MD/PhDAssociate Professor of Medicine
Division of RheumatologyUniversity of Colorado School of Medicine
July 13, 2014
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Outline
Advances in understanding OA development
Advances in OA treatments
Possible Prevention
![Page 3: Osteoarthritis (OA): Updates on development, treatment and possible prevention Kevin Deane, MD/PhD Associate Professor of Medicine Division of Rheumatology.](https://reader035.fdocuments.in/reader035/viewer/2022062407/56649dc85503460f94abd50e/html5/thumbnails/3.jpg)
Images courtesy AAOS
![Page 4: Osteoarthritis (OA): Updates on development, treatment and possible prevention Kevin Deane, MD/PhD Associate Professor of Medicine Division of Rheumatology.](https://reader035.fdocuments.in/reader035/viewer/2022062407/56649dc85503460f94abd50e/html5/thumbnails/4.jpg)
PAIN LOSS OF FUNCTIO
N
![Page 5: Osteoarthritis (OA): Updates on development, treatment and possible prevention Kevin Deane, MD/PhD Associate Professor of Medicine Division of Rheumatology.](https://reader035.fdocuments.in/reader035/viewer/2022062407/56649dc85503460f94abd50e/html5/thumbnails/5.jpg)
Why does OA develop?
‘Old’ theory = injury to cartilage
‘New’ theory = injury to cartilage
BUT! Greater understanding of how the immune system interacts to drive progression of OA
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Early days
But understanding how inflammation relates to OA should lead to treatments and prevention
![Page 7: Osteoarthritis (OA): Updates on development, treatment and possible prevention Kevin Deane, MD/PhD Associate Professor of Medicine Division of Rheumatology.](https://reader035.fdocuments.in/reader035/viewer/2022062407/56649dc85503460f94abd50e/html5/thumbnails/7.jpg)
Cartilage is prime component of the joint
Genetic issue = cartilage problem = easy to damage = OA
If a component of that damage is inflammation that could be blocked – could lead to treatment or
prevention
WARNING: LONG WAY TO GO!
Breakdown of cartilage is different that tissues that require cartilage for development
![Page 8: Osteoarthritis (OA): Updates on development, treatment and possible prevention Kevin Deane, MD/PhD Associate Professor of Medicine Division of Rheumatology.](https://reader035.fdocuments.in/reader035/viewer/2022062407/56649dc85503460f94abd50e/html5/thumbnails/8.jpg)
OA Treatments
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Mainstays
1) Pain medications (acetaminophen, opiates)2) Anti-inflammatory medications (ibuprofen,
naproxen)3) Steroid injections4) Physical therapy5) Surgery – total joint replacement
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Newer Treatments
1) Viscosupplementation (injections)
2) Glucosamine chondroitin sulfate
3) Surgical cartilage repair
4) Partial joint replacements and resurfacing
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Is prevention of OA possible?
![Page 12: Osteoarthritis (OA): Updates on development, treatment and possible prevention Kevin Deane, MD/PhD Associate Professor of Medicine Division of Rheumatology.](https://reader035.fdocuments.in/reader035/viewer/2022062407/56649dc85503460f94abd50e/html5/thumbnails/12.jpg)
What is ‘prevention’?
Identification and stopping of a disease at an early time point before major problems develop Primary:Stop disease before it stopsExamples: vaccines, removal of standing water
Secondary:Find disease at a very early, treatable stageExamples: Breast and colon cancer
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NO DISEASE
Risk factors may be present
EARLY DISEASE
May be without symptoms
FULL BLOWN DISEASE
Primary Prevention
Secondary Prevention
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Keys for Prevention
Know what causes disease
Know who will get disease before they get it Tests, risks factors
Have a program to identify those who are at-risk
Have a treatment that works to prevent disease
Cost effective
Adapted from World Health Organization guidelines
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OA Prevention
Certain risk factors are known - injury - mechanics - genetic conditions
Learning more about how to identify those at risk
Learning more about disease and finding targets for prevention
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Recent Work Towards Prevention
MRI identifies subtle early findings of OA
Can be used to identify those at future risk while they are in a phase of disease that can be potentially modified
Sharma et al. Arthritis and Rheumatology 2014
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Recent Work Towards Prevention
Injection of anti-inflammatory agent into joint after injury prevents future arthritis
A mechanism for prevention!
Mouse study!
Furman et al Arthritis Research and Therapy 2014
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Questions