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Chronological effects of non-steroidal anti-inflammatory drug therapy on oxidative stress and antioxidant status in patients with rheumatoid arthritis

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Abstract

Introduction/Objectives

Non-steroidal anti-inflammatory drugs (NSAIDs) are effective in reducing pain and inflammation in rheumatoid arthritis and other joint- and muscle-associated diseases. However, the extensive, long-term, and over the counter administration of NSAIDs may cause various side effects in the patients. In the present study, the chronological effect of NSAIDs on oxidative stress and antioxidant status in patients with rheumatoid arthritis was studied.

Methods

The study included 100 female individuals categorized in four major groups: (1) control group consisting of age- and gender-matched healthy individuals, (2) NRA-NSAID individuals taking NSAIDs without any history of RA, (3) RA individuals with a history of RA but not taking NSAIDs, and (4) RA-NSAID individuals with chronic RA and taking NSAIDs for a long period. The sera of the participants were analyzed for the oxidative stress and antioxidant status.

Results

The RA-NSAID group showed the significantly highest oxidative stress, in terms of malondialdehyde content and lipid-reducing ability as determined in thiocyanate and hemoglobin-induced linoleic acid systems. However, the free radical scavenging ability of the RA-NSAID group, against 2,2-diphenyl-1-picrylhydrazyl, hydroxyl, superoxide, and 2,2-azino-bis-tetrazolium sulfate radicals, was found to be lower than those of the other study groups. The regression analysis of the experimental data showed a significant positive relationship between duration of NSAID intake and malondialdehyde production, lipid-reducing ability, and metal chelating ability in the RA-NSAID patients. The free radical scavenging abilities of the RA-NSAID group were negatively correlated with the duration of NSAID intake.

Conclusions

The prolonged use of NSAIDs significantly increased the oxidative stress and decrease the antioxidant potential of both the RA patients and NRA individuals. The study provides awareness to the public particularly the RA patients regarding the risk of oxidative stress–associated abnormalities caused by the frequent and prolonged use of NSAIDs for temporary relief from pain.

Key Points

• The study presents the effects of long-term use of non-steroidal anti-inflammatory drugs (NSAIDs) on antioxidant status of patients with rheumatoid arthritis.

• The continuous administration of NSAIDs has been found to significantly increase the oxidative stress of the patients with rheumatoid arthritis as well as the individuals with no signs of rheumatoid arthritis.

• The prolonged NSAID therapy also decreased the antioxidant potential of the patients with rheumatoid arthritis as well as the individuals with no signs of rheumatoid arthritis.

• The study would be a significant and valuable contribution to the literature for the awareness regarding the use of NSAIDs.

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Data availability

All data generated or analyzed during this study are included in this article.

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Acknowledgments

The authors are grateful to the Department of Biochemistry, Bahauddin Zakariya University for providing the basic facilities to conduct this research study.

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Authors and Affiliations

  1. Department of Biochemistry, Bahauddin Zakariya University, Multan, 60800, Pakistan

    Haq Nawaz & Asma Ali

  2. Department of Chemistry, The Women University Multan, Multan, 60800, Pakistan

    Tanzila Rehman

  3. Faisalabad Medical University, Faisalabad, 38000, Pakistan

    Amna Aslam

Authors
  1. Haq Nawaz
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  2. Asma Ali
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  3. Tanzila Rehman
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  4. Amna Aslam
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Contributions

Haq Nawaz contributed to the study design, supervised the entire research project from hypothesis to completion, and takes responsibility for the integrity and accuracy of the data. Asma Ali contributed to designing the project, sample collection, and experimental work in the laboratory. Tanzila Rehman and Amna Aslam contributed to the data analysis and write up of the manuscript.

Corresponding author

Correspondence to Haq Nawaz.

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The study was approved by the Board of Advanced Studies and Research and Departmental Ethical Committee and conducted at the Department of Biochemistry, Bahauddin Zakariya University, Multan, Pakistan, and the written informed consent was obtained from all participants.

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Nawaz, H., Ali, A., Rehman, T. et al. Chronological effects of non-steroidal anti-inflammatory drug therapy on oxidative stress and antioxidant status in patients with rheumatoid arthritis. Clin Rheumatol 40, 1767–1778 (2021). https://doi.org/10.1007/s10067-020-05438-0

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  • DOI: https://doi.org/10.1007/s10067-020-05438-0

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