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Sağlıklı sıçanlarda intra-artiküler tenoksikam, diklofenak ve metilprednizolonun kronik etkilerinin karşılaştırılması

Year 2015, , 438 - 446, 19.08.2015
https://doi.org/10.3944/AOTT.2015.14.0312

Abstract

Amaç: Dejeneratif eklem hastalığı tedavisinde nonsteroid antiinflamatuar ilaçların (NSAİİ) uzun süreli kullanımından kaynaklanan gastrointestinal yan etkilere karşılık olarak liyofilize NSAİİ üretimi ve intra-artiküler (İA) uygulamaları artmıştır. Diz içine enjekte edilen liyofilize NSAİİ (tenoksikam) ile kortikosteroid (metilprednizolon asetat) ve liyofilize olmayan NSAİİ’nin (diklofenak) tekrarlayan uygulamalarının zararlı etkileri histopatolojik olarak araştırılmıştır.

Gereçler ve Yöntemler: Denekler, her biri 25 sıçan içeren dört gruba bölünmüştür; kontrol, metilprednizolon, tenoksikam ve diklofenak. Sıçanların sağ dizlerine bir haftalık aralıklarla toplam 10 doz İA enjeksiyon gerçekleştirilmiştir. Sıçanlar, onuncu enjeksiyondan 48 saat, 1, 2, 4 ve 8 hafta sonra sakrifiye edilmiştir. Histomorfolojik olarak, diz eklemleri osteoartritik değişiklikler bakımından incelenirken mide dokusu da gastritik değişiklikler yönünden incelenmiştir.

Bulgular: Diklofenak ve tenoksikam diz ekleminde artmış fibroblast ve fibrozis oluşumuna yol açarken, kortikosteroid artmış fibroblast ve fibrozis oluşumuna yol açmamış; kronik kortikosteroid kullanımı aynı zamanda sinovyum veya kıkırdak doku üzerinde hiçbir negatif etki oluşturmamıştır.

Çıkarımlar: Kronik tenoksikam ve diklofenak kullanımı diz ekleminde metilprednizolona kıyasla daha fazla negatif etki oluşturmuştur.

 

DOI: 10.3944/AOTT.2015.14.0312

Bu özet, makalenin henüz redaksiyonu tamamlanmamış haline aittir ve bilgi verme amaçlıdır. Yayın aşamasında değişiklik gösterebilir.

References

  • Brandt KD. Diagnosis and nonsurgical management of os- teoarthritis. First Edition. Caddo, OK: Professional Com- munications, Inc. 1996. [ISBN: 1–884735–09–6]
  • Cook TM, Tuckey JP, Nolan JP. Analgesia after day-case knee arthroscopy: double-blind study of intra-articular tenoxicam, intra-articular bupivacaine and placebo. Br J Anaesth 1997;78:163–8.
  • Colbert ST, Curran E, O’Hanlon DM, Moran R, Mc- Carroll M. Intra-articular tenoxicam improves post- operative analgesia in knee arthroscopy. Can J Anaesth 1999;46:653–7.
  • Uthman I, Raynauld JP, Haraoui B. Intra-articular therapy in osteoarthritis. Postgrad Med J 2003;79:449–53.
  • Ozyuvaci H, Bilgic B, Ozyuvaci E, Altan A, Altug T, Ka- raca C. Intra-articular injection of tenoxicam in rats: as- sessment of the local effects on the articular cartilage and synovium. J Int Med Res 2004;32:312–6.
  • Peckett WR, Butler-Manuel A. Intra-articular steroids af- ter arthroscopy for osteoarthritis of the knee. J Bone Joint Surg Br 2000;82:775–6.
  • Brandt KD. Management of osteoartritis. In Ruddy S, Ha- ris ED Jr, Sledge CB, editors. Kelley’s Texbook of Rheu- matology. 6th ed. Philadelphia: W.B. Saunders Company 2001. pp. 1419–32.
  • Recommendations for the medical management of osteo- arthritis of the hip and knee: 2000 update. American Col- lege of Rheumatology Subcommittee on Osteoarthritis Guidelines. Arthritis Rheum 2000;43:1905–15.
  • Riggin CN, Tucker JJ, Soslowsky LJ, Kuntz AF. Intra-ar- ticular tibiofemoral injection of a nonsteroidal anti-inflam- matory drug has no detrimental effects on joint mechanics in a rat model. J Orthop Res 2014;32:1512–9.
  • Blot L, Marcelis A, Devogelaer JP, Manicourt DH. Effects of diclofenac, aceclofenac and meloxicam on the metabo- lism of proteoglycans and hyaluronan in osteoarthritic hu- man cartilage. Br J Pharmacol 2000;131:1413–21.
  • Ding C. Do NSAIDs affect the progression of osteoarthri- tis? Inflammation 2002;26:139–42.
  • Notoya K, Jovanovic DV, Reboul P, Martel-Pelletier J, Mineau F, Pelletier JP. The induction of cell death in hu- man osteoarthritis chondrocytes by nitric oxide is related to the production of prostaglandin E2 via the induction of cyclooxygenase-2. J Immunol 2000;165:3402–10.
  • Henroitin Y, Reginster JY. In-vitro differences among non- steroidal antiinflammatory drugs in their activities related to osteoarthritis pathophysiology. Osteoarthritis Cartilage 1999;7:355–7.
  • Mukherjee P, Rachita C, Aisen PS, Pasinetti GM. Non- steroidal anti-inflammatory drugs protect against chon- drocyte apoptotic death. Clin Exp Rheumatol 2001;19(1 Suppl 22):7–11.
  • Guler G, Karaoglu S, Velibasoglu H, Ramazanogullari N, Boyaci A. Comparison of analgesic effects of intra-articu- lar tenoxicam and morphine in anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 2002;10:229–32.
  • Oztuna V, Eskandari M, Bugdayci R, Kuyurtar F. Intra-ar- ticular injection of tenoxicam in osteoarthritic knee joints with effusion. Orthopedics 2007;30:1039–42.
  • Kirdemir P, Marsan A, Gogus N, Tabak Y, Tekin M. Com- parison between the analgesic effects of intraarticular neo- stigmine, tramadol and tenoxicam. Acta Orthop Trauma- tol Turc 2001;35:358–62.
  • Elhakim M, Nafie M, Eid A, Hassin M. Combination of intra-articular tenoxicam, lidocaine, and pethidine for outpatient knee arthroscopy. Acta Anaesthesiol Scand 1999;43:803–8.
  • Saricaoglu F, Dal D, Atilla P, Iskit AB, Tarhan O, Aşan E, et al. Effect of intraarticular injection of lornoxicam on the articular cartilage & synovium in rat. Indian J Med Res 2008;127:362–5.
  • Lane NE, Thompson JM. Management of osteoarthritis in the primary-care setting: an evidence-based approach to treatment. Am J Med 1997;103:25–30.
  • Godwin M, Dawes M. Intra-articular steroid injections for painful knees. Systematic review with meta-analysis. Can Fam Physician 2004;50:241–8.
  • Pelletier JP, Martel-Pelletier J. Recent developments in the therapy of osteoarthritis. In: Tsokos GC, editor. Modern Therapeutics in Rheumatic Diseases. Totowa, NJ: Huma- na Press; 2002. pp. 253–5.
  • Pasquali Ronchetti I, Guerra D, Taparelli F, Boraldi F, Bergamini G, Mori G, et al. Morphological analysis of knee synovial membrane biopsies from a randomized controlled clinical study comparing the effects of sodium hyaluronate (Hyalgan) and methylprednisolone acetate (Depomedrol) in osteoarthritis. Rheumatology (Oxford) 2001;40:158–69.
  • Gosal HS, Jackson AM, Bickerstaff DR. Intra-articular steroids after arthroscopy for osteoarthritis of the knee. J Bone Joint Surg Br 1999;81:952–4.
  • Ratiner B, Gramas DA, Lane NE. Osteoarthritis. In: Weisman MH, Weinblatt ME, Louis JS, editors. Treat- ment of the Rheumatic Diseases. Companion to Kelley’s Textbook of Rheumatology. 2nd ed. Philadelphia: W.B. Saunders Company; 2001. pp. 461–86.
  • Ayral X. Injections in the treatment of osteoarthritis. Best Pract Res Clin Rheumatol 2001;15:609–26.
  • Creamer P. Intra-articular corticosteroid injections in os- teoarthritis: do they work and if so, how? Ann Rheum Dis 1997;56:634–6.
  • Gossec L, Dougados M. Intra-articular treatments in os- teoarthritis: from the symptomatic to the structure modi- fying. Ann Rheum Dis 2004;63:478–82.
  • Gossec L, Dougados M. Do intra-articular therapies work and who will benefit most? Best Pract Res Clin Rheumatol 2006;20:131–44.
  • Kirwan J. Is there a place for intra-articular hyaluronate in osteoarthritis of the knee? Knee 2001;8:93–101.
  • Kirwan JR, Rankin E. Intra-articular therapy in osteoar- thritis. Baillieres Clin Rheumatol 1997;11:769–94.
  • Schumacher HR, Chen LX. Injectable corticoste
  • roids in treatment of arthritis of the knee. Am J Med 2005;118:1208–14.
  • Raynauld JP, Buckland-Wright C, Ward R, Choquette D, Haraoui B, Martel-Pelletier J, et al. Safety and efficacy of long-term intraarticular steroid injections in osteoarthri- tis of the knee: a randomized, double-blind, placebo-con- trolled trial. Arthritis Rheum 2003;48:370–7.
  • Jaffré B, Watrin A, Loeuille D, Gillet P, Netter P, Laugier P, et al. Effects of antiinflammatory drugs on arthritic car- tilage: a high-frequency quantitative ultrasound study in rats. Arthritis Rheum 2003;48:1594–601.

Comparison of the effects of chronic intra-articular administration of tenoxicam, diclofenac, and methylprednisolone in healthy rats

Year 2015, , 438 - 446, 19.08.2015
https://doi.org/10.3944/AOTT.2015.14.0312

Abstract

Objective: Lyophilized drug manufacturing and intra-articular (IA) applications have increased to address gastrointestinal side effects resulting from chronic treatment with non-steroidal anti-inflammatory drugs (NSAIDs) for degenerative joint disease. Accordingly, we histologically examined joint and stomach tissues from rats to determine and compare the effects of long-term treatment with an IA corticosteroid (methylprednisolone acetate), lyophilized NSAID (tenoxicam), and non-lyophilized NSAID (diclofenac) following application to the knee joint.
Methods: One hundred Wistar albino rats were divided into 4 groups of 25 rats: control, methylprednisolone, tenoxicam, and diclofenac. Ten IA injections were administered at 1-week intervals. Rats were sacrificed at 48 h and 1, 2, 4, and 8 weeks after the tenth injection. Histomorphologically, knee joint samples were examined for osteoarthritic changes and stomach tissue samples for gastric changes.
Results: Unlike methylprednisolone, diclofenac and tenoxicam caused increased fibrosis and fibroblast production; furthermore, chronic methylprednisolone use had no negative effects on the synovium or cartilage.
Conclusion: Chronic tenoxicam and diclofenac use affects joints more negatively than chronic steroid treatment.

References

  • Brandt KD. Diagnosis and nonsurgical management of os- teoarthritis. First Edition. Caddo, OK: Professional Com- munications, Inc. 1996. [ISBN: 1–884735–09–6]
  • Cook TM, Tuckey JP, Nolan JP. Analgesia after day-case knee arthroscopy: double-blind study of intra-articular tenoxicam, intra-articular bupivacaine and placebo. Br J Anaesth 1997;78:163–8.
  • Colbert ST, Curran E, O’Hanlon DM, Moran R, Mc- Carroll M. Intra-articular tenoxicam improves post- operative analgesia in knee arthroscopy. Can J Anaesth 1999;46:653–7.
  • Uthman I, Raynauld JP, Haraoui B. Intra-articular therapy in osteoarthritis. Postgrad Med J 2003;79:449–53.
  • Ozyuvaci H, Bilgic B, Ozyuvaci E, Altan A, Altug T, Ka- raca C. Intra-articular injection of tenoxicam in rats: as- sessment of the local effects on the articular cartilage and synovium. J Int Med Res 2004;32:312–6.
  • Peckett WR, Butler-Manuel A. Intra-articular steroids af- ter arthroscopy for osteoarthritis of the knee. J Bone Joint Surg Br 2000;82:775–6.
  • Brandt KD. Management of osteoartritis. In Ruddy S, Ha- ris ED Jr, Sledge CB, editors. Kelley’s Texbook of Rheu- matology. 6th ed. Philadelphia: W.B. Saunders Company 2001. pp. 1419–32.
  • Recommendations for the medical management of osteo- arthritis of the hip and knee: 2000 update. American Col- lege of Rheumatology Subcommittee on Osteoarthritis Guidelines. Arthritis Rheum 2000;43:1905–15.
  • Riggin CN, Tucker JJ, Soslowsky LJ, Kuntz AF. Intra-ar- ticular tibiofemoral injection of a nonsteroidal anti-inflam- matory drug has no detrimental effects on joint mechanics in a rat model. J Orthop Res 2014;32:1512–9.
  • Blot L, Marcelis A, Devogelaer JP, Manicourt DH. Effects of diclofenac, aceclofenac and meloxicam on the metabo- lism of proteoglycans and hyaluronan in osteoarthritic hu- man cartilage. Br J Pharmacol 2000;131:1413–21.
  • Ding C. Do NSAIDs affect the progression of osteoarthri- tis? Inflammation 2002;26:139–42.
  • Notoya K, Jovanovic DV, Reboul P, Martel-Pelletier J, Mineau F, Pelletier JP. The induction of cell death in hu- man osteoarthritis chondrocytes by nitric oxide is related to the production of prostaglandin E2 via the induction of cyclooxygenase-2. J Immunol 2000;165:3402–10.
  • Henroitin Y, Reginster JY. In-vitro differences among non- steroidal antiinflammatory drugs in their activities related to osteoarthritis pathophysiology. Osteoarthritis Cartilage 1999;7:355–7.
  • Mukherjee P, Rachita C, Aisen PS, Pasinetti GM. Non- steroidal anti-inflammatory drugs protect against chon- drocyte apoptotic death. Clin Exp Rheumatol 2001;19(1 Suppl 22):7–11.
  • Guler G, Karaoglu S, Velibasoglu H, Ramazanogullari N, Boyaci A. Comparison of analgesic effects of intra-articu- lar tenoxicam and morphine in anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 2002;10:229–32.
  • Oztuna V, Eskandari M, Bugdayci R, Kuyurtar F. Intra-ar- ticular injection of tenoxicam in osteoarthritic knee joints with effusion. Orthopedics 2007;30:1039–42.
  • Kirdemir P, Marsan A, Gogus N, Tabak Y, Tekin M. Com- parison between the analgesic effects of intraarticular neo- stigmine, tramadol and tenoxicam. Acta Orthop Trauma- tol Turc 2001;35:358–62.
  • Elhakim M, Nafie M, Eid A, Hassin M. Combination of intra-articular tenoxicam, lidocaine, and pethidine for outpatient knee arthroscopy. Acta Anaesthesiol Scand 1999;43:803–8.
  • Saricaoglu F, Dal D, Atilla P, Iskit AB, Tarhan O, Aşan E, et al. Effect of intraarticular injection of lornoxicam on the articular cartilage & synovium in rat. Indian J Med Res 2008;127:362–5.
  • Lane NE, Thompson JM. Management of osteoarthritis in the primary-care setting: an evidence-based approach to treatment. Am J Med 1997;103:25–30.
  • Godwin M, Dawes M. Intra-articular steroid injections for painful knees. Systematic review with meta-analysis. Can Fam Physician 2004;50:241–8.
  • Pelletier JP, Martel-Pelletier J. Recent developments in the therapy of osteoarthritis. In: Tsokos GC, editor. Modern Therapeutics in Rheumatic Diseases. Totowa, NJ: Huma- na Press; 2002. pp. 253–5.
  • Pasquali Ronchetti I, Guerra D, Taparelli F, Boraldi F, Bergamini G, Mori G, et al. Morphological analysis of knee synovial membrane biopsies from a randomized controlled clinical study comparing the effects of sodium hyaluronate (Hyalgan) and methylprednisolone acetate (Depomedrol) in osteoarthritis. Rheumatology (Oxford) 2001;40:158–69.
  • Gosal HS, Jackson AM, Bickerstaff DR. Intra-articular steroids after arthroscopy for osteoarthritis of the knee. J Bone Joint Surg Br 1999;81:952–4.
  • Ratiner B, Gramas DA, Lane NE. Osteoarthritis. In: Weisman MH, Weinblatt ME, Louis JS, editors. Treat- ment of the Rheumatic Diseases. Companion to Kelley’s Textbook of Rheumatology. 2nd ed. Philadelphia: W.B. Saunders Company; 2001. pp. 461–86.
  • Ayral X. Injections in the treatment of osteoarthritis. Best Pract Res Clin Rheumatol 2001;15:609–26.
  • Creamer P. Intra-articular corticosteroid injections in os- teoarthritis: do they work and if so, how? Ann Rheum Dis 1997;56:634–6.
  • Gossec L, Dougados M. Intra-articular treatments in os- teoarthritis: from the symptomatic to the structure modi- fying. Ann Rheum Dis 2004;63:478–82.
  • Gossec L, Dougados M. Do intra-articular therapies work and who will benefit most? Best Pract Res Clin Rheumatol 2006;20:131–44.
  • Kirwan J. Is there a place for intra-articular hyaluronate in osteoarthritis of the knee? Knee 2001;8:93–101.
  • Kirwan JR, Rankin E. Intra-articular therapy in osteoar- thritis. Baillieres Clin Rheumatol 1997;11:769–94.
  • Schumacher HR, Chen LX. Injectable corticoste
  • roids in treatment of arthritis of the knee. Am J Med 2005;118:1208–14.
  • Raynauld JP, Buckland-Wright C, Ward R, Choquette D, Haraoui B, Martel-Pelletier J, et al. Safety and efficacy of long-term intraarticular steroid injections in osteoarthri- tis of the knee: a randomized, double-blind, placebo-con- trolled trial. Arthritis Rheum 2003;48:370–7.
  • Jaffré B, Watrin A, Loeuille D, Gillet P, Netter P, Laugier P, et al. Effects of antiinflammatory drugs on arthritic car- tilage: a high-frequency quantitative ultrasound study in rats. Arthritis Rheum 2003;48:1594–601.
There are 35 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Experimental Study
Authors

Mehmet Orak This is me

Dursun Ak This is me

Ahmet Midi

Berna Lacin This is me

Sevim Purisa This is me

Guven Bulut

Publication Date August 19, 2015
Published in Issue Year 2015

Cite

APA Orak, M., Ak, D., Midi, A., Lacin, B., et al. (2015). Comparison of the effects of chronic intra-articular administration of tenoxicam, diclofenac, and methylprednisolone in healthy rats. Acta Orthopaedica Et Traumatologica Turcica, 49(4), 438-446. https://doi.org/10.3944/AOTT.2015.14.0312
AMA Orak M, Ak D, Midi A, Lacin B, Purisa S, Bulut G. Comparison of the effects of chronic intra-articular administration of tenoxicam, diclofenac, and methylprednisolone in healthy rats. Acta Orthopaedica et Traumatologica Turcica. August 2015;49(4):438-446. doi:10.3944/AOTT.2015.14.0312
Chicago Orak, Mehmet, Dursun Ak, Ahmet Midi, Berna Lacin, Sevim Purisa, and Guven Bulut. “Comparison of the Effects of Chronic Intra-Articular Administration of Tenoxicam, Diclofenac, and Methylprednisolone in Healthy Rats”. Acta Orthopaedica Et Traumatologica Turcica 49, no. 4 (August 2015): 438-46. https://doi.org/10.3944/AOTT.2015.14.0312.
EndNote Orak M, Ak D, Midi A, Lacin B, Purisa S, Bulut G (August 1, 2015) Comparison of the effects of chronic intra-articular administration of tenoxicam, diclofenac, and methylprednisolone in healthy rats. Acta Orthopaedica et Traumatologica Turcica 49 4 438–446.
IEEE M. Orak, D. Ak, A. Midi, B. Lacin, S. Purisa, and G. Bulut, “Comparison of the effects of chronic intra-articular administration of tenoxicam, diclofenac, and methylprednisolone in healthy rats”, Acta Orthopaedica et Traumatologica Turcica, vol. 49, no. 4, pp. 438–446, 2015, doi: 10.3944/AOTT.2015.14.0312.
ISNAD Orak, Mehmet et al. “Comparison of the Effects of Chronic Intra-Articular Administration of Tenoxicam, Diclofenac, and Methylprednisolone in Healthy Rats”. Acta Orthopaedica et Traumatologica Turcica 49/4 (August 2015), 438-446. https://doi.org/10.3944/AOTT.2015.14.0312.
JAMA Orak M, Ak D, Midi A, Lacin B, Purisa S, Bulut G. Comparison of the effects of chronic intra-articular administration of tenoxicam, diclofenac, and methylprednisolone in healthy rats. Acta Orthopaedica et Traumatologica Turcica. 2015;49:438–446.
MLA Orak, Mehmet et al. “Comparison of the Effects of Chronic Intra-Articular Administration of Tenoxicam, Diclofenac, and Methylprednisolone in Healthy Rats”. Acta Orthopaedica Et Traumatologica Turcica, vol. 49, no. 4, 2015, pp. 438-46, doi:10.3944/AOTT.2015.14.0312.
Vancouver Orak M, Ak D, Midi A, Lacin B, Purisa S, Bulut G. Comparison of the effects of chronic intra-articular administration of tenoxicam, diclofenac, and methylprednisolone in healthy rats. Acta Orthopaedica et Traumatologica Turcica. 2015;49(4):438-46.