Department of Joint Replacement and Tissue Engineering, Hokkaido University Graduate School of Medicine, Kita-15, Nishi-7, Kita-ku, Sapporo, 060-8638, Japan.
Mod Rheumatol. 2013 Sep;23(5):934-8. doi: 10.1007/s10165-012-0772-0. Epub 2012 Sep 22.
Non-steroidal anti-inflammatory drugs play a major role in the management of osteoarthritis (OA). However, it remains unknown whether these drugs affect cartilage and synovial metabolism in osteoarthritic joints. The aim of this study was to evaluate the effects of a selective cyclooxygenase (COX)-2 inhibitor, celecoxib, on synovial fluids and tissues in severely osteoarthritic knees.
Patients were randomized into three groups and medicated two weeks prior to total knee arthroplasty with celecoxib, diclofenac sodium, or no medication (control). We checked for the presence of matrix metalloproteinase-3 (MMP-3), tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), and hyaluronic acid (HA) in the synovial fluids of all three groups.
MMP-3 significantly decreased in the celecoxib-treated patients (p = 0.0031). On the other hand, there were no significant differences among the three groups in their TNF-α and IL-1β levels. HA in the joint fluid was significantly increased in the diclofenac-treated group, while HA was not changed in the celecoxib-treated patients.
Our study suggests that celecoxib did not affect the level of HA in the joint fluid in the knee in severe OA, in contrast to the effect of the dual COX inhibitor.
非甾体抗炎药在骨关节炎(OA)的治疗中起着重要作用。然而,这些药物是否会影响骨关节炎关节的软骨和滑膜代谢尚不清楚。本研究旨在评估选择性环氧化酶(COX)-2 抑制剂塞来昔布对严重膝关节骨关节炎患者的滑膜液和组织的影响。
患者随机分为三组,在全膝关节置换术前两周分别给予塞来昔布、双氯芬酸钠或不给予药物(对照组)治疗。我们检查了三组患者滑膜液中基质金属蛋白酶-3(MMP-3)、肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)和透明质酸(HA)的存在情况。
塞来昔布治疗组的 MMP-3 显著降低(p = 0.0031)。另一方面,三组患者的 TNF-α 和 IL-1β 水平无显著差异。关节液中的 HA 在双氯芬酸钠治疗组中显著增加,而塞来昔布治疗组的 HA 没有变化。
我们的研究表明,与双重 COX 抑制剂相比,塞来昔布对严重 OA 膝关节关节液中的 HA 水平没有影响。