The Discovery of Drugs to Treat Arthritis: A Historical View
Ivan G. Otterness · Birkhäuser Boston eBooks · 1995
The discovery of drugs to treat arthritis mirrors in many ways the discoveries and developments that have taken place in all areas of pharmacology. Yet in other ways, the discovery of drugs for arthritis remains unique. Sodium salicylate was the first useful synthetic drug for arthritis, and the discovery of new drugs has continued unabated to the present, making this one of the most commercially important therapeutic areas. The first analgesic/ anti-inflammatory drugs set the tone—competition was between unique chemical entities protected by patents. Thus, competition became focused on structural differentiation which could lead to improvements in safety or efficacy. Yet in spite of the many commercial successes and the discovery resources poured into the area over the last century, arthritis therapy has remained a bastion of empirically discovered drugs. With the exception of the cyclooxygenäse inhibitors, even today the mechanism of action of the principal drugs still is not fully understood. It is not clear if this counterintuitive outcome arises from the history of the subject, or whether it is based on the difficulty of the therapeutic target. In the absence of a cure for arthritis, all improvements in therapy, however small, have been welcomed enthusiastically. It can be hoped that advances in cellular physiology, in receptor biology, ion channels, enzymology, and molecular biology will bring a rationalization of drug discovery and, with it, bring us a great deal closer to the ideal therapeutic for arthritis.