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Archive for August, 2011

Heel Wedge

Heel Wedge

Dr. Lynn Snyder-Mackler recently published a trial that addressed the question:  Do lateral wedge insoles or flat control insoles improve symptoms and slow structural disease progression in medial knee osteoarthritis?

The study concluded that lateral wedge insoles worn for 12 months provided no symptomatic or structural benefits compared with flat control insoles.

The double blind randomized control trial looked at 200 patients with qualified knee pain from osteoarthritis.  Participants wore insoles in both of their shoes everyday for 12 months.  Every four months they switched between the lateral wedge insole and the flat insole.

The results after 12 months is that lateral wedge insoles worn for one year provided no symptomatic or structural benefits compared with flat control insoles.

Back to the Drawing Board

Back to the Drawing Board

Doxycycline is an antibiotic and is being considered as a disease modifying osteoarthritis drug (DMOAD).  It is used to treat infections.  Doxycycline has been found to inhibit the enzyme metalloproteinase.  This enzyme helps destroy cartilage.  Some research has suggested that doxycycline helps slow OA’s progression.

A recent Dutch study looked at how doxycycline effects pain and function in patient with OA.  Unfortunately the study showed that doxycycline is not effective in reducing symptomatic pain, stiffness, or function in knee OA.  Also it was associated with negative side effects.

So it’s back to the drawing board for synthetic metalloproteinase inhibitors.

Future OA Treatments

Future OA Treatments

Are DMOADs the future?  Many physicians and researchers believe that Disease Modifying Osteoarthritis Drugs are exactly that.

One of the arrows missing from the physician’s quiver of treatment options for osteoarthritis is disease modification.  However, to date the pharmaceutical industry has failed to bring effective and safe disease modifying OA treatments to the market.  Clinical trials are underway researching compounds that inhibit matrix-metalloproteinases (MMPs), bisphosphonates, cytokine blockers, calcitonin, inhibitors of inducible nitric oxide synthase (iNOS), doxycycline, glucosamine, and diacereine.

Early results are positive, showing that some interventions have been shown to slow the progression of osteoarthritis, and several new classes of molecules have been discovered that inhibit one or more “OA pathophysiological processes”.

We will let you know as more information on any of these treatment options become available.