Priority Medicines for Europe and the World 2013 Update. Background Paper 6 - Priority Diseases and Reasons for Inclusion. BP 6.12 - Osteoarthritis
(2013; 31 pages)

In 2004, a report Priority Medicines for Europe and the World was written by Warren Kaplan and Richard Laing and published by the World Health Organization (WHO). A chapter (6.12) and background paper on osteoarthritis were written for this publication by Saloni Tanna.

Osteoarthritis (OA), the most common musculoskeletal condition, is a long-term chronic disease involving the thinning of cartilage in joints which results in bones rubbing together, creating stiffness, pain, and impaired movement. OA is related with age, but is associated with a variety of both modifiable and non-modifiable risk factors, including obesity, lack of exercise, genetic predisposition, bone density, occupational injury, trauma, and gender.

Osteoarthritis is a major cause of disability in elderly populations around the globe, especially in developed countries. The prevalence of OA is increasing and will continue to do so as the population increases, ages, and is subject to risk factors such as the obesity epidemic. As OA causes pain and impairs functionality of the patient, it places a major burden on individuals, communities, health systems, and social care systems.

The current control strategy mainly consists of palliative pain treatment, as there are several medicines on the market that alleviate pain and improve function in OA patients. In severe cases, joint replacement surgery has been proven effective in relieving the painful and debilitating effects of the disease, though the high cost and use of advanced resources mean these procedures are not available in many countries around the world. There are currently no therapies available that can reverse or halt the progression of osteoarthritis; larger studies are needed to evaluate the clinical and cost effectiveness of the few therapies that have shown promise in animal trials.

Another principal aspect of osteoarthritis care that requires further research is diagnostic techniques. The current methods of clinical diagnosis and X-rays are not precise enough to effectively measure status and progression of the condition, which presents serious difficulties in evaluating both the impact of risk factors and the effectiveness of potential therapies. The lack of valid biomarkers limits pharmaceutical development and clinical monitoring.

The issues presented by the lack of both reliable diagnostics and medicines that can reverse the progression of osteoarthritis must be addressed through further research in order to effectively reduce the large health and economic burden of osteoarthritis.

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