1. Osteoarthritis The need for innovative therapeutic options?

3. OA – multiple spheres of influence

4. OA – multiple influences Injury Obesity Biomechanics Genetics Age / Sex Metabolic abnormalities Subchondral bone changes

6. DMOADs DMOADs What they need to do How they need to do Delay structural progression Prevent the OA Effect on Radiographic Joint Space Narrowing (JSN) Effect on progression to control JSN and pain / function relation Halting progression (improving the x-ray) Reversing progression (normalizing the x-ray)

8. Role of IL-1

9. Role of different therapies

10. Role of different therapies Diacerein Steroids NSAIDs

11. DMOAD clinical targets

12. DMOAD clinical targets

13. DMOAD clinical trials

14. DMOAD clinical trials

19. Case study 1 – before & after therapy with diacerein Before treatment After treatment

20. Case study 2 – before & after therapy with diacerein Before treatment After treatment

21. Case study 3 – before & after therapy with diacerein Before treatment After treatment

22. Study1 Arch Intern Med. 2006;166:1899-1906

23. Study2 Arch Intern Med. 2006;166:1899-1906

24. Study3 Arch Intern Med. 2006;166:1899-1906

25. Study4 Arch Intern Med. 2006;166:1899-1906

26. Study5 Arch Intern Med. 2006;166:1899-1906

27. Study6 Arch Intern Med. 2006;166:1899-1906

30. Summary of the studies