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Do NSAIDs Affect the Progression of Osteoarthritis?

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Abstract

NSAIDs are widely used to alleviate the symptoms of OA. It remains controversial as to what effects these agents have on the progression of OA. In vitro studies showed several types of NSAIDs (e.g., sodium salicylate, indomethacin) inhibited the synthesis of cartilage matrix component, but some types of NSAIDs (e.g., aceclofenac, meloxicam, nimesulide) increased the matrix component synthesis and protected the chondrocytes against apoptosis, while others (e.g., piroxicam) had no effects. Studies in animal models verified that NSAIDs had favourable or detrimental action on OA progression, even the same NSAID (e.g., naproxen, tiaprofenic acid) had reverse effects on articular cartilage in different studies. Preliminary clinical trials revealed some NSAIDs such as indomethacin had a negative influence on joint structure, other NSAIDs such as diclofenac and naproxen had no acceleration of radiographic damage to OA within 2-years of treatment. So far, there are no convincing data to show the widely used NSAIDs and recommended selective COX-2 inhibitor have favourable effects on cartilage. Therefore, it is necessary and valuable to clarify the effects of these NSAIDs on cartilage in patients with OA using validated non-invasive methods such as MRI.

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REFERENCES

  1. Felson, D. T. and Y. Zhang. 1998. An update on the epidemiology of knee and hip osteoarthritis with a view to prevention. Arthritis Rheumatol. 41: 1343–1355.

    Google Scholar 

  2. Goldring, M. B. 2000. The role of the chondrocyte in osteoarthritis.Arthritis Rheumatol. 43: 1916–1926.

    Google Scholar 

  3. Hungin, A. P. S. and D. W. F. Kean. 2001. Nonsteroidal antiin-flammatory drugs: overused or underused in osteoarthritis? Am. J.Med. 110(1a): 8s–11s.

    Google Scholar 

  4. Blot, L., A. Marcelis, J. P. Devogelaer, and D. P. Manicourt. 2000.Effects of diclofenac, aceclofenac and meloxicam on metabolism of proteoglycans and hyaluronan in osteoarthritis human cartilage.Br. J. Pharmacol. 131: 1413–1421.

    Google Scholar 

  5. Mukherjee, P., C. Rachita, P. S. Aisen, and G. M. Pasinetti. 2001.Non-steroidal anti-inflammatory drugs protect against chondrocyte apoptotic death. Clin. Exp. Rheumatol. 19(1 Suppl 22): S7–11.

    Google Scholar 

  6. Notoya K, D. V. Jovanovic, and P. Reboul et al. 2000. The induction of cell death in human osteoarthritis chondrocytes by nitric oxide is related to the production of prostaglandin E2 via the induction of cyclooxygenase-2. J. Immunol. 165(6): 3402–3410.

    Google Scholar 

  7. Dingle, J. 1996. Effects of NSAIDs on human articular glycosaminoglycan synthesis. Eur. J. Rheu. Inflam. 16: 47–52.

    Google Scholar 

  8. Henrotin, Y. and T. Y. Reginster. 1999. In vitro differences among nonsteroidal antiinflammatory drugs in their activities related to osteoarthritis pathophysiology. Osteoarthritis Cartilage. 7: 355–357.

    Google Scholar 

  9. Serni U., A. Mannoni, and M. Benucci. 1999. Is there preliminary in-vivo an influence of nonsteroidal antiinflammatory drug treatment on osteoarthritis progression? Part II-evidence from animal models. Osteoarthritis Cartilage. 7: 351–352.

    Google Scholar 

  10. Ratcliffe, A., M. P. Rosenwasser, and F. Mahmud et al. 1993. The in vivo effects of naproxen on canine experimental osteoarthritic articular cartilage: composition, metalloproteinase activities and metabolism. Agents Actions Suppl. 39: 207–211.

    Google Scholar 

  11. Pelletier J. P., D. Lajeunesse, and D. V. Jovanovic et al. 2000.Carprofen simultaneously reduces progression of morphological changes in cartilage and subchondral bone in experimental dog osteoarthritis. J. Rheumatol. 27(12): 2893–2902.

    Google Scholar 

  12. Fernandes J. C., J. P. Caron, and J. Martel-Pelletier et al. 1997.Effects of tenidap on the progression of osteoarthritic lesions in a canine experimental model. Suppression of metalloprotease and interleukin-1 activity. Arthritis Rheum. 40(2): 284–294.

    Google Scholar 

  13. Chan C. C., S. Boyce, and C. Brideau et al. 1999. Rofecoxib: A potent and orally active cyclooxygenase-2 inhibitor. Pharmacological and biochemical profiles. J Pharmacol. Exp. Ther. 290: 551–560.

    Google Scholar 

  14. Gencosmanoglu, B. E., M. Eryavuz, and S. Dervisoglu. 2001.Effects of some nonsteroidal anti-inflammatory drugs on articular cartilage of rats in an experimental model of osteoarthritis. Res.Exp. Med. 200(3): 215–226.

    Google Scholar 

  15. Rashad S., P. Revell, and A. Hemingway et al. 1989. Effect of non steroidal antiinflammatory drugs on the course of osteoarthritis.Lancet. 2: 519–522.

    Google Scholar 

  16. Huakinsson E. C., H. Berry, and P. Gishen et al. on behalf of the LINK study group. 1995. Effects of antiinflammatory drugs on the progression of osteoarthritis of the knee. J. Rheumatol. 22: 1941–1946.

    Google Scholar 

  17. Dieppe P., J. Cushnaghan, and M. K. Jasani et al. 1993. A twoyear, placebo-controlled trial of non-steroidal nonantiflammatory therapy in osteoarthritis of the knee joint. Br. J. Rheumatol. 32: 595–600.

    Google Scholar 

  18. Williams H. J., J. R. Ward, and M. J. Egger et al. 1993. Comparison of naproxen and acetaminophen in a two-year study of the treatment of osteoarthritis of the knees. Arthritis Rheum. 36: 1196–1206.

    Google Scholar 

  19. Sharma S., S. Rastogi, V. Gupta, D. Rohtagi, and P. Gulati. 1999.Comparative efficacy and safety of nimesulide versus piroxicam in osteoarthritis with special reference to chondroprotection. Am.J. Ther. 6(4): 191–197.

    Google Scholar 

  20. Recommendations for the registration of drugs used in the treatment of osteoarthritis. 1996. Ann. Rheu. Dis. 55: 552–557.

  21. Pelletier, J. P. 1999. The influence of tissue cross-talking on OA progression: Role of nonsteroidal antiinflammatory drugs.Osteoarthritis Cartilage. 7: 374–376.

    Google Scholar 

  22. Mcmanus P., J. G. Pimrose, and D. A. Henry et al. 1996. Pattern of non-steroidal antiinflammatory drug in Australia 1990–1994. Med.J. Aust. 164: 589–592.

    Google Scholar 

  23. Lipsky, P. E. 2001. Recommendation for the clinical use of cyclooxygenase-2-specificied inhibitors. Am. J. Med. 110(3A): 3s–5s.

    Google Scholar 

  24. Jones G., M. Glisson, K. Hynes, and F. Cicuttini. 2000. Sex and site differences in cartilage development: a possible explanation for variations in knee osteoarthritis in later life. Arthritis Rheum. 43(11): 2543–2549.

    Google Scholar 

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Ding, C. Do NSAIDs Affect the Progression of Osteoarthritis?. Inflammation 26, 139–142 (2002). https://doi.org/10.1023/A:1015504632021

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