Osteoarthritis (OA) is a degenerative joint disease that frequently affects the hands and weight bearing joints of the body [1]. In United States, 52.5 million adults have been diagnosed with osteoarthritis according to data analyzed between 2010 and 2012 in the National Health Interview Survey (NHIS) [2]. In addition, OA is considered as one of the main causes of functional disability in (estimated) 22.7 million US adults [3]. The patient with OA is suffering not only from the persistent pain, stiffness and limited mobility. However, it also directly affects their quality of life with physical and/or mental co-morbidity [4]. OA substantially increases health care expenditures which is estimated around $ 128 billion [5]. When considering productivity loss due to OA, estimates are between 0.25 and 0.50% of the Gross Domestic Product (GDP) [5].
Osteoarthritis (OA) is poorly understood because of its vast complexity and interplay of various biological factors such as: genetic alterations, sex hormone deficit, and aging [6]. Many recent evidence has focused on molecular markers that implicated in the stress-induced senescent state of chondrocytes [7]. The term “Chondrosenescence” has been currently used to describe the age-dependent deterioration of chondrocyte function [8]. The therapeutic approaches for OA are limited because of its complex pathophysiology. According to the Osteoarthritis Research Society International (OARSI) Guidelines and recommendations for OA management, a core set of evidence based-modalities of therapy has been established [9]. These modalities included non-pharmacological such as patient education and awareness, physical exercise and rehabilitation aids. The pharmacological modalities vary from prescription of acetaminophen, non-selective NSAIDs (Nonsteroidal anti-inflammatory drugs) and selective COX-2 inhibitors agents and even opioid prescription. NSAIDs are the most prescribed agents for OA [10]. Despite NSAIDs established effectiveness in relieving the pain with OA its long term use is associated with potential harmful adverse effects. In addition, there is a wide heterogeneity in their personalized response because of the pharmacogenomics interactions.
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