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Outcomes and Western Ontario and McMaster Universities Osteoarthritis Index Score Reporting in a Trial of the Efficacy and Safety of Diclofenac–Hyaluronate Conjugate: Comment on the Article by Nishida et al

In managing hand OA, the primary goals are to control pain and improve joint function. However, the treatment of pain with pharmacologic agents may result in various side effects. Thus, the development of novel preventive and therapeutic strategies for the treatment of this disease is urgently needed. We agree with Sirufo and colleagues that our findings will help investigators understand the role of the microbiome in the development of symptomatic hand OA and could reveal new perspectives on the development of novel therapeutic strategies for OA. We believe that future studies assessing the causal associations of key microbial species and related metabolites with OA should further address the underlying mechanisms (i.e., interactions between microRNAs and the microbiome [1,2]) and explore potential targets for intervention, which could provide novel alternatives to current treatment regimens for this common and dis abling disease.