Vascular mechanisms in osteoarthritis

Ghosh P, Cheras PA · Best Practice & Research. Clinical Rheumatology

The argument that gives an anticoagulant a reason to be an arthritis drug: cartilage-derived antigens provoke synovitis, whose pro-coagulant mediators tip subchondral vessels toward hypercoagulation, hypofibrinolysis and ischaemic bone necrosis — from which the authors predict that agents that are simultaneously antithrombotic, lipid-lowering and anti-inflammatory should slow OA.

Population

Narrative review of subchondral vascular pathology in osteoarthritis

Intervention

n/a

Comparator

n/a

Limitations

A hypothesis paper by PPS's developer, arguing for the drug class he developed; the vascular model remains the least directly tested leg of the mechanism, and the trial designed to test it in humans — MaRVeL, which enrols only people with dyslipidaemia — has not reported.