Pain relievers such as ibuprofen and naproxen can make arthritis inflammation worse

Taking anti-inflammatory ache relievers such as ibuprofen and naproxen for osteoarthritis might worsen knee inflammation over time, based on new analysis.

Taking anti-inflammatory ache relievers for osteoarthritis, such as ibuprofen and naproxen, can make knee inflammation worse over time. That’s based on a brand new examine introduced subsequent week on the Radiological Society of North America’s (RSNA) annual assembly.

As the most typical type of arthritis, osteoarthritis (OA) impacts greater than 32 million adults within the United States and greater than 500 million individuals worldwide. It normally happens on the fingers, hips and knees. In individuals with osteoarthritis, the cartilage that cushions the joints step by step wears away. This is typically referred to as degenerative joint illness or “put on and tear” arthritis. Arthritis is usually accompanied by inflammation or swelling of the joint, which can be painful.

Nonsteroidal anti-inflammatory medication (NSAIDs) are generally prescribed for the ache and inflammation of osteoarthritis. Common NSAIDs embody ibuprofen (Advil, Motrin) and naproxen (Aleve). However, little is thought in regards to the long-term results of those medication on illness development.

“To date, no healing remedy has been accepted to treatment or sluggish the development of knee osteoarthritis,” stated the examine’s lead creator, Johanna Luitjens, a postdoctoral researcher within the Department of Radiology and Biomedical Imaging on the University of California, San Francisco. “NSAIDs are sometimes used to deal with ache, however it’s nonetheless an open debate how NSAID use impacts outcomes for sufferers with osteoarthritis. In specific, the impact of NSAIDs on synovitis or joint inflammation has by no means been analyzed utilizing MRI-based structural biomarkers.” .

NSAIDs may worsen arthritis inflammation

Fat adjoining to the knee cap (Hoffa’s fats pad, infrapatellar fats pad) can alter the MRI sign when the knee is infected. (A) Normal knee with out indicators of inflammation. (B) Arrow pointing to a restricted space of ​​excessive sign (mild traces) within the (normally darkish) area of the fats pad, indicating the onset of an inflammatory response. (C) The complete fats space has a excessive sign (mild grey coloration with white traces), an indication of progressive inflammation of the knee joint. Credit: RSNA and Johanna Luitjens

Dr. Luitjens and colleagues got down to analyze the connection between NSAID use and synovitis in sufferers with knee osteoarthritis and to judge how therapy with NSAIDs impacts joint construction over time.

“Synovitis mediates the event and development of osteoarthritis and could also be a therapeutic goal,” says Dr. Luitjens stated. “Therefore, the aim of our examine was to investigate whether or not NSAID therapy impacts the event or development of synovitis and to research whether or not NSAID therapy impacts cartilage imaging biomarkers that replicate adjustments in osteoarthritis.”

For the examine, 277 individuals from the Osteoarthritis Initiative cohort with average to extreme osteoarthritis and who had been on common NSAID therapy for at the very least one 12 months between baseline and 4 years of follow-up have been included within the examine and in contrast with a bunch of 793 management individuals. Not handled with NSAIDs. All individuals underwent 3T MRI of the knee at baseline and 4 years later. Images have been scored for biomarkers of inflammation.

Cartilage thickness, composition, and different MRI measurements have served as noninvasive biomarkers to evaluate the development of arthritis.

The outcomes confirmed no long-term advantage of NSAID use. Joint inflammation and cartilage high quality have been worse at baseline in comparison with the management group in individuals taking NSAIDs and worsened at four-year follow-up.

“In this huge group of individuals, we have been in a position to present that NSAIDs don’t have any protecting mechanisms to scale back inflammation or sluggish the development of knee osteoarthritis,” stated Dr. Luitjens stated. “The use of NSAIDs for his or her anti-inflammatory perform has turn out to be widespread in osteoarthritis sufferers lately and must be reconsidered, as no constructive impact on joint inflammation can be demonstrated.”

According to Dr. Luitjens, there are a number of doable explanation why NSAID use will increase synovitis.

“On the one hand, the anti-inflammatory impact normally brought on by NSAIDs doesn’t stop synovitis with worsening synovitis and progressive degenerative adjustments over time,” he stated. “On the opposite hand, sufferers with synovitis who’re taking ache remedy could also be bodily energetic due to the ache reduction, which can worsen the synovitis, however we adjusted for bodily exercise in our mannequin.”

Dr. Luitjens famous that potential, randomized research must be carried out sooner or later to offer clear proof of the anti-inflammatory results of NSAIDs.

Co-authors Charles McCulloch, Ph.D., Thomas Link, MD, Ph.D., Felix Gassert, MD, Gabby Joseph, Ph.D., and John Lynch, Ph.D.

Meeting: 108th Scientific Assembly and Annual Meeting of the Radiological Society of North America

Leave a Comment

Your email address will not be published. Required fields are marked *