Nonsteroidal anti-inflammatory drugs in therapy for osteoarthrosis

Abstract

It is noted that nonsteroidal anti-inflammatory drugs (NSAIDs) hold a special position in the treatment of osteoarthrosis (OA). Most conventional NSAIDs are considered to enhance cartilage degeneration. Whether NSAIDs have a negative effect on the progression of OA is the subject of wide speculation. Experiments have established that NSAIDs affect the metabolism of the hyaline cartilage in a different manner in relation to the stage of OA and the duration of treatment. The negative effect of NSAIDs on the articular cartilage gives grounds to recommend their short-term use in OA and only on its exacerbation or severe joint pains and in the inefficiency of simple analgesics. At the same time there is evidence that some NSAIDs, aceclofenac (Aertal) in particular, are able to restrain the apoptosis of chondroblasts and chondrocytes and to stimulate their production of proteoglycans. It has been ascertained that in OA aceclofenac stimulated chondroblasts and chondrocytes to elaborate adequate proteoglycans, glycosaminoglycans, and hyaluronic acid, i.e. it produces a chondroprotective effect.