Pain relievers such as ibuprofen and naproxen may exacerbate arthritis inflammation

Taking anti-inflammatory pain relievers such as ibuprofen and naproxen for osteoarthritis can exacerbate knee joint inflammation over time. due to new scientific research to be presented at the annual meeting of

Osteoarthritis (OA), the most common form of arthritis, affects more than 32 million people in the United States and more than 500 million people worldwide. It occurs most commonly in the hands, hips, and knees. In people with osteoarthritis, the cartilage that cushions the joints wears away over time. This is why it is sometimes called degenerative joint disease or “wear and tear” arthritis. Arthritis often involves inflammation or swelling of the joints, which can be painful.

Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly prescribed for osteoarthritis pain and inflammation. Common NSAIDs include ibuprofen (Advil, Motrin) and naproxen (Aleve). However, little is known about the long-term effects of these drugs on disease progression.

“To date, there are no approved treatments to cure or reduce the progression of knee osteoarthritis,” said lead author of the study, Ph.D., Department of Radiology and Biomedical Imaging at the University of California, San Francisco. Researcher Johanna Luitjens said. “NSAIDs are frequently used to treat pain, but how their use affects outcomes in patients with osteoarthritis is still controversial. The effects of NSAIDs on inflammation of the membranes overlying the cytoplasm have never been analyzed using MRI-based structural biomarkers.

Dr. Luitjens and colleagues will analyze the association between NSAID use and synovitis in patients with knee osteoarthritis and assess how treatment with NSAIDs affects joint structures over time. started.

“Synovitis mediates the development and progression of osteoarthritis and may be a therapeutic target,” Dr. Luitjens said. “Therefore, the goal of our study was to analyze whether NSAID treatment affects the development or progression of synovitis, and to identify cartilage imaging biomarkers that reflect changes in osteoarthritis to determine the impact of NSAID treatment.” It was to investigate whether or not I would receive it.”

In this study, 277 participants in the Osteoarthritis Initiative cohort who had moderate to severe osteoarthritis and had at least 1 year of ongoing NSAID treatment between baseline and 4 years of follow-up. were included in the study and compared with a group of 793 control participants. Not treated with NSAIDs. All participants underwent her 3T MRI of the knee initially and after her 4 years. Images were scored for biomarkers of inflammation.

Cartilage thickness, composition, and other MRI measurements served as noninvasive biomarkers to assess arthritis progression.

Results showed no long-term benefits of NSAID use. Joint inflammation and cartilage quality worsened at baseline and at 4 years of follow-up in participants taking NSAIDs compared to controls.

“In this large group of participants, we were able to demonstrate that there is no protective mechanism from NSAIDs in reducing inflammation or slowing the progression of knee osteoarthritis,” said Luitjens. “The use of NSAIDs for their anti-inflammatory function has become increasingly prevalent in patients with osteoarthritis in recent years, and needs to be revisited, as positive effects on joint inflammation have not been demonstrated,” Dr. I have.”

According to Dr. Luitjens, there are several possible reasons for the increase in synovitis with NSAID use.

“On the other hand, the usual anti-inflammatory effects of NSAIDs may not effectively prevent synovitis, and progressive degenerative changes may exacerbate synovitis over time,” she says. said. “On the other hand, patients with synovitis and taking pain medications may be physically more active for pain relief, which may lead to worsening of synovitis. We adjusted physical activity in our model.”

Dr. Luitjens pointed out that future prospective randomized trials are needed to provide definitive evidence of the anti-inflammatory effects of NSAIDs.

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

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