[Do 'chondroprotective agents' agents exist in osteoarthritis? Required proof].

Abstract

The term 'chondroprotective agent' must be dropped in favour of that of structure-modifying drug which allows consideration of the global process of osteoarthritis (OA). A structure-modifying drug is defined as being able to prevent, retard, stabilize or even reverse all or a part of the lesions of bone and cartilage which form the structure of human OA. The demonstration of an eventual structure-modifying effect can only be provided by the proof of a favourable result on the anatomical lesions of OA. The measurement of joint-space narrowing by manual 'radiochondrometry' or performed by computer is presently the 'method of choice', but requires the strict respect of standardized rules during the radiographic procedure. MRI may allow, in the future, a satisfactory assessment of the volume of articular cartilage. Chondroscopy permits a direct evaluation of lesions but is an invasive technique. Molecular markers still lack reliability. Until now, no drug has been able to provide well-established proof of a real effect of structuromodulation.