Expert Opin Drug Deliv . 2020 Jun 16. doi: 10.1080/17425247.2020.1783234. Online ahead of print.

The Perspectives of Intra-Articular Therapy in the Management of Osteoarthritis

Alberto Migliore  ¹ , Marco Paoletta  ² , Antimo Moretti  ² , Sara Liguori  ² , Giovanni Iolascon  ²

Abstract

Management of Osteoarthritis (OA) still is a challenge for clinicians. Taking into account a multidisciplinary approach including pharmacological and non-pharmacological treatments, intra-articular (IA) injection could be considered as an effective local therapy. Areas covered: this review provides new perspective of IA treatment going beyond current available IA agents. We describe novel biological targets for developing new IA agents and innovative modalities of delivery systems. Additional topics include predictors of response for a better choice of IA agents for each patient, diagnostic and prognostic role of biomarkers, improve the accuracy of IA injection, and cost-effectiveness of IA injection. Expert opinion: IA treatments seem to be very promising for the management of OA. Identifying clinical and biochemical predictive factors could drive clinician to the appropriate therapeutic approach. To date there is a gap regarding the benefit of IA treatment in the "real practice" once they have been adopted. However, considering these promising effects of IA approach, several open questions remain not clarified.