Using common pain relievers for osteoarthritis? It’s time to do a rethink

Common painkillers, such as ibuprofen and naproxen, used by the osteoarthritis patients, may not actually help

More than 500 million people worldwide suffer from osteoarthritis, which is a common form of arthritis. And the most sought after medication happens to be taking anti-inflammatory pain relievers like ibuprofen and naproxen. However, no one has thought for a second whether these pain relievers would actually help patients with osteoarthritis!

Osteoarthritis afflicts the hands, hips and knees. Patients with osteoarthritis experience the wearing away of the cartilage that cushions the joints. The condition comes with inflammation of the joint, causing much pain.

Latest research has found that the common painkillers such as ibuprofen and naproxen, used by the osteoarthritis-afflicted, actually worsens the condition. The new study has stated that though non-steroidal anti-inflammatory drugs (NSAIDs) are commonly prescribed for osteoarthritis pain and inflammation, the long-term effects of these drugs on disease progression are still unknown. As per the findings, no curative therapy has been approved to cure or reduce the progression of knee osteoarthritis.

NSAID for osteoarthritis needs to be revisited

Johanna Luitjens, the study’s lead author and postdoctoral scholar in the Department of Radiology and Biomedical Imaging at the University of California, San Francisco, has been quoted saying that NSAIDs are frequently used to treat pain, but it is still an open discussion of how their use influences outcomes for osteoarthritis patients. The impact of NSAIDs on synovitis, or the inflammation of the membrane lining the joint, has never been analysed using MRI-based structural biomarkers, Luitjens added. The study will be presented soon at the annual meeting of the Radiological Society of North America (RSNA).

Researchers will now attempt to gauge the link between NSAID use and synovitis in patients with osteoarthritis of the knee. They will also look at assessing how treatment with NSAIDs affects joint structure over time.  It has been found that synovitis mediates development and progression of osteoarthritis and may be a therapeutic target. And so, the study tried to find out whether NSAID treatment influences the development or progression of synovitis and to investigate whether cartilage imaging biomarkers, which reflect changes in osteoarthritis, are impacted by NSAID treatment, the RSNA has said.

Latest research holds much significance

The study had included 277 participants from the Osteoarthritis Initiative, and had interviewed patients with moderate to severe osteoarthritis conditions and sustained NSAID use for at least one year between baseline and four-year follow-up. They were compared with a group of 793 control participants who had not been treated with NSAIDs. All the participants had undergone 3T MRI of the knee initially and after four years. Images were scored for biomarkers of inflammation, it added.

The study took into account cartilage thickness, composition and other MRI measurements as non-invasive biomarkers for evaluating arthritis progression. Going by the results, it was found that NSAID use had provided no long-term benefit. Besides, joint inflammation and cartilage quality were worse at baseline in the participants taking NSAIDs, compared to the control group, and worsened at four-year follow-up. This meant that there are actually no protective mechanisms from NSAIDs in reducing inflammation or slowing down progression of osteoarthritis of the knee joint.

These findings hold much significance, and it has become imperative that use of NSAIDs for their anti-inflammatory function needs to have a rethink, as no positive effect was recorded in the patients

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