[Targeted anti-cytokine therapies for osteoarthritis]

Abstract

Proinflammatory cytokines such as interleukin-1 beta and, to a lesser extent, tumor necrosis factor (TNF) alpha, play a key role in the destruction of the cartilage matrix in osteoarthritis. Intraarticular injection of specific IL-I inhibitors or antagonists has been shown to slow disease progression in animal models of osteoarthritis. A first randomized placebo-controlled trial of a IL-1 beta antagonist (a single intraarticular injection of 50 or 150 mg) had no analgesic effect during 3 months of follow-up. However, 150 mg of IL-1 ra had an early analgesic effect. Anti-TNF alpha therapy has also been tested in isolated cases of digital and knee osteoarthritis. Cytokine targeting in osteoarthritis is thus an appealing approach but one that needs to be validated in terms of the risk-benefit ratio.