Do NSAIDs Affect Longitudinal Changes in Knee Cartilage Volume and Knee Cartilage Defects in Older Adults? - 12/08/11
, Flavia Cicuttini, PhD b, Graeme Jones, MD a
Requests for reprints should be addressed to Changhai Ding, MD, Menzies Research Institute, Private Bag 23, Hobart, Tasmania 7000, AustraliaAbstract |
Background |
The effects of nonsteroidal anti-inflammatory drugs (NSAIDs) on knee osteoarthritis progression are unclear. The aim of this longitudinal study was to determine the associations between use of NSAIDs and changes in knee cartilage volume and knee cartilage defects over 2.9 years in older adults.
Methods |
T1-weighted fat-suppressed magnetic resonance imaging on the right knee was performed in a total of 395 randomly selected subjects (mean age 62 years, range 51-80 years, and 50% female) to assess knee cartilage volume at tibial sites and knee cartilage defects (0-4 scale) at baseline and 2.9 years later. Medication use in the last month was recorded by questionnaire.
Results |
Compared with nonusers of NSAIDs (n=334), users of cyclooxygenase (COX)-2 inhibitors (n=40) had decreased knee cartilage defect development in the medial tibiofemoral compartment (odds ratio [OR] 0.4, 95% confidence interval [CI], 0.2-0.99), whereas users of conventional NSAIDs (n=21) had increased knee cartilage defect development in both medial (OR 3.1, 95% CI, 1.0-9.1) and lateral (OR 2.6, 95% CI, 1.0-6.7) tibiofemoral compartments. Comparing users of COX-2 inhibitors with users of conventional NSAIDs, the latter had higher knee cartilage volume loss (−5.3% vs −3.1% at medial tibia and −3.6% vs −1.1% at lateral tibia; all P <.05). All associations were adjusted for potential confounders including knee pain and radiographic osteoarthritis.
Conclusions |
This study suggests that nonselective NSAIDs may have deleterious effects, while selective COX-2 inhibitors might have beneficial effects on knee cartilage. Randomized controlled trials examining knee structure to confirm this finding are warranted.
Le texte complet de cet article est disponible en PDF.Keywords : Cartilage loss, Knee, Magnetic resonance imaging, Nonsteroidal anti-inflammatory drugs, Osteoarthritis
Plan
| Funding: National Health and Medical Research Council of Australia; Arthritis Foundation of Australia; Tasmanian Community Fund; University of Tasmania Grant-Institutional Research Scheme. |
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| Conflict of Interest: Dr. Jones has worked as a consultant, speaker, and clinical trialist with Pfizer, MSD, Roche, and Novartis, all of which manufacture NSAIDs. However, none of these companies had any input into the writing of this article. Other authors have nothing to declare. |
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| Authorship: All authors had access to the data in the study. Study design: Ding, Cicuttini, Jones. Acquisition of data: Ding, Jones. Analysis and interpretation of data: Ding, Cicuttini, Jones. Manuscript preparation: Ding, Cicuttini, Jones. Statistical analysis: Ding, Jones. |
Vol 122 - N° 9
P. 836-842 - septembre 2009 Retour au numéro
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