Pain Relievers Like Ibuprofen and Naproxen May Worsen Arthritis Inflammation

Arthritis Knee Pain X-ray Illustration

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According to brand-new research study, taking anti-inflammatory painkiller like ibuprofen and naproxen for osteoarthritis might really aggravate swelling in the knee joint gradually.

Taking anti-inflammatory painkiller like ibuprofen and naproxen for osteoarthritis might aggravate swelling in the knee joint gradually. This is according to a brand-new clinical research study existing at the yearly conference of the Radiological Society of North America (RSNA) next week.

As the most typical type of arthritis, osteoarthritis (OA) impacts more than 32 million grownups in the U.S. and more than 500 million individuals worldwide. It takes place most regularly in the hands, hips, and knees. In individuals with osteoarthritis, the cartilage that cushions the joint slowly deteriorates. This is why it is in some cases called degenerative joint illness or “wear and tear” arthritis. Arthritis is frequently accompanied by swelling, or swelling, of the joint, which can be unpleasant.

Non- steroidal anti-inflammatory drugs (NSAIDs) are typically recommended for osteoarthritis discomfort and swelling. Common NSAIDs consist of Ibuprofen (Advil, Motrin) and naproxen (Aleve). However, little is understood about the long-lasting impacts of these drugs on illness development.

“To date, no curative therapy has been approved to cure or reduce the progression of knee osteoarthritis,” stated the research study’s lead author, Johanna Luitjens, postdoctoral scholar in the Department of Radiology and Biomedical Imaging at the University of California, SanFrancisco “NSAIDs are frequently used to treat pain, but it is still an open discussion of how NSAID use influences outcomes for osteoarthritis patients. In particular, the impact of NSAIDs on synovitis, or the inflammation of the membrane lining the joint, has never been analyzed using MRI-based structural biomarkers.”

NSAIDs May Worsen Arthritis Inflammation

The fat pad surrounding to the kneecap (Hoffa’s fat pad, infrapatellar fat pad) can alter in signal on MRI when the knee is swollen. (A) Normal knee without indications of swelling. (B) Arrow pointing on a circumscribed location with greater signal (brilliant lines) in the location of the fat pad (typically dark), which is a sign of a starting inflammatory response. (C) The entire fat pad has a greater signal (light grey color with white lines), which suggests progressive swelling of the knee joint. Credit: RSNA and Johanna Luitjens

Dr Luitjens and associates set out to evaluate the association in between NSAID usage and synovitis in clients with osteoarthritis of the knee and to examine how treatment with NSAIDs impacts joint structure gradually.

“Synovitis mediates development and progression of osteoarthritis and may be a therapeutic target,”Dr Luitjens stated. “Therefore, the goal of our study was to analyze 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.”

For the research study, 277 individuals from the Osteoarthritis Initiative accomplice with moderate to extreme osteoarthritis and continual NSAID treatment for a minimum of one year in between standard and four-year follow-up were consisted of in the research study and compared to a group of 793 control individuals who were not treated with NSAIDs. All individuals went through 3T MRI of the knee at first and after 4 years. Images were scored for biomarkers of swelling.

Cartilage density, structure, and other MRI measurements acted as noninvasive biomarkers for assessing arthritis development.

The results revealed no long-lasting advantage of NSAID usage. Joint swelling and cartilage quality were even worse at standard in the individuals taking NSAIDs, compared to the control group, and aggravated at four-year follow-up.

“In this large group of participants, we were able to show that there were no protective mechanisms from NSAIDs in reducing inflammation or slowing down the progression of osteoarthritis of the knee joint,”Dr Luitjens stated. “The use of NSAIDs for their anti-inflammatory function has been frequently propagated in patients with osteoarthritis in recent years and should be revisited, since a positive impact on joint inflammation could not be demonstrated.”

According toDr Luitjens, there are a number of possible reasons NSAID usage increases synovitis.

“On the one hand, the anti-inflammatory effect that normally comes from NSAIDs may not effectively prevent synovitis, with progressive degenerative change resulting in worsening of synovitis over time,” she stated. “On the other hand, patients who have synovitis and are taking pain-relieving medications may be physically more active due to pain relief, which could potentially lead to worsening of synovitis, although we adjusted for physical activity in our model.”

Dr Luitjens kept in mind that potential, randomized research studies ought to be carried out in the future to supply definitive proof of the anti-inflammatory effect of NSAIDs.

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

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

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