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Table 1 Current and emerging arthritis treatments and their mode of action and side effects

From: Current and emerging therapeutic strategies for preventing inflammation and aggrecanase-mediated cartilage destruction in arthritis

Therapeutic agent

Mode of action

Side effects


Methotrexate [39]

Inhibits purine and pyrimidine synthesis and suppresses cytokine synthesis

Abdominal discomfort, alopecia, oral ulcerations and cytopenia, diarrhea, nausea, alopecia, vomiting, hepatotoxicity, and infections

Chloroquine, quinachrine, and hydroxychloroquine [40]

Anti-inflammatory, inhibition of cytokine diffusion

Sulfasalazine [41]

Decreases pain and swelling

Leflunomide [42]

Inhibits de novo pyrimidine synthesis

Biological agents

Infliximab [47],[54]

TNF inhibitors

Nausea, upper respiratory tract infections, dyspepsia, and headaches

Golimumab [44]

Adalimumab [46]

Etanercept [45]

Rituximab [50]

B-cell inhibitor (CD20)


T-cell inhibitor

Tocilizumab [43],[48]

IL-6R inhibitor


IL-1R inhibitor


Prednisolone [54]


Weight gain, immunosuppression, altered glycemic control, glaucoma, hypertension, and osteoporosis

Aspirin (acetylsalicylic acid)


Gastrointestinal ulcer perforation and bleeding, renal impairment, and platelet dysfunction





Therapeutic agent

Mode of action

Key observations


Simvastatin [56]-[58],[66]


Suppression of macrophage infiltration and bone destruction (rat), decreased MMP-3 (rat), decreased migration and invasion of fibroblast-like synoviocytes (cells), and mild improvements in DAS28 scores and swollen joint counts (human)

Atorvastatin [59],[60],[64]

Anti-inflammatory Cartilage anabolism Cartilage protection

Decreased systemic TNF-α (human); reduction in C-reactive protein and erythrocyte sedimentation and improved DAS28 scores (human); and decreased IL-1β and MMP-13 and increased aggrecan and ColIIa1 (in vitro human osteoarthritic chondrocytes)

Rosuvastatin [63]


Reduction of C-reactive protein (human)

Mevastatin [65]

Anti-inflammatory Cartilage protection

Reduction in IL-1β, MMP-3, and MMP-13 (rabbit)

  1. Common arthritis treatments that target inflammation and pain are shown. Disease-modifying anti-rheumatic drugs (DMARDs) used for rheumatoid arthritis target systemic inflammation, whereas biological agents target localized inflammatory cytokines. Corticosteroids and non-steroidal anti-inflammatory drugs (NSAIDs) are often used for both rheumatoid arthritis and osteoarthritis treatments. Cholesterol-lowering drugs (statins) target inflammation and prevent cartilage breakdown in varying rheumatoid arthritis and osteoarthritis contexts. DAS28, Disease Activity Score in 28 Joints; IL, interleukin; MMP, matrix metalloproteinase; TNF, tumor necrosis factor.