Abstract
Peptide-based strategies offer promising solutions to overcome the complex, multi-tissue barriers of osteoarthritis. Their tunability, specificity, and versatility enable targeted drug delivery to cartilage, synovium, and subchondral bone, while some therapeutic peptides provide intrinsic anti-inflammatory, regenerative, or analgesic effects. Advances in peptide design, stability engineering, and in silico screening, alongside emerging human joint-on-chip models, are accelerating the development of targeted, stable, multi-tissue OA therapies.