Faculty Opinions recommendation of Mechanistic pain profiling as a tool to predict the efficacy of 3-week nonsteroidal anti-inflammatory drugs plus paracetamol in patients with painful knee osteoarthritis.

Abstract Objective: Through the bioinformatics analysis, to identify the genes and pathways of nonsteroidal anti-inflammatory drugs(NSARDs) acting on synovia from women with knee osteoarthritis (KOA), and to provide reference for clinical application. Methods: We downloaded the gene microarray datasets with the accession number of GSE55457 and GSE55584 from the Gene Expression Omnibus (GEO; https://www.ncbi.nlm.nih.gov/geo/) database, including 5 untreated KOA patients, 9 NSARDs treated KOA patients and 2 patients without KOA The samples in the untreated KOA group and the NSARDs treated KOA group were used for main analysis. The samples in the untreated KOA group and the normal control group were used for cooperative analysis. Then we performed robust multi-array (RMA) normalization with affy R programming package. After that, differential expression genes (DEGs) in main analysis and cooperative analysis were identified based on limma package separately. Screening the common DEGs from main analysis and cooperative analysis. Enriched gene ontology (GO) terms and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways of DEGs were obtained through the Database for Annotation, Visualization and Integrated Discovery (DAVID). What's more, protein-protein interaction (PPI) network was constructed, and we identified modules of PPI network through Cytoscape to screen valuable targets. The value of gene expression fold change (FC) ≥1.4 or ≤1/1.4, and P <0.05 were used as the screening conditions. P <0.05 and Associated genes count>5 were used as the screening conditions.Results: There were 338 DEGs in main analysis. Among them, 211 genes were up-regulated and 127 genes were down-regulated. There were 7005 DEGs in cooperative analysis. Among them, 6952 genes were up-regulated and 53 genes were down-regulated. A total of 129 common DEGs were identified between main analysis and cooperative analysis. There are 2 biological processes, 3 cell components and 2 molecular functions for the enrichment of differentially expressed genes.Conclusion: NSARDs may play a certain role in synovia from women with KOA by regulating the mRNA expressions of il-6, TNFRSF11A and CSF1R, which may become one of the indicators for monitoring the efficacy of NSAIDs.

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The Comparative Efficacy and Safety of Long- and Short-Term Continuous Use of Non-Steroidal Anti-Inflammatory Drugs for the Treatment of Knee Osteoarthritis

Traumatology and Orthopedics of Russia ◽

10.21823/2311-2905-2020-26-2-120-127 ◽

2020 ◽

Vol 26 (2) ◽

pp. 120-127

Author(s):

B. V. Zavodovskiy ◽

E. V. Papichev ◽

L. E. Sivordova ◽

Yu. V. Polyakova ◽

Yu. R. Akhverdyan

Keyword(s):

Knee Osteoarthritis ◽

Pain Syndrome ◽

Pain Level ◽

Short Term ◽

On Demand ◽

Average Pain ◽

Inflammatory Drugs ◽

Anti Inflammatory ◽

Continuous Use

Objective. To compare the efficacy and tolerability of long-term and short-term continuous NSAIDs in patients with knee osteoarthritis with insufficient efficacy “on demand” NSAIDs and SYSADOA.Study design. 12-week, prospective, comparative, randomized, single-center study.Materials and Methods. 180 patients with primary knee osteoarthritis aged 40 to 85 years with insufficient efficacy of “on demand” NSAIDs and SYSADOA were examined. Anti-inflammatory drugs were recommended for everyone: 56 people took Naproxen (31.11%), 63 — Etoricoxib (35%), 61 — Ketoprofen (33.89%). Patients were randomized into two groups: 1st group — with 8-week continuous intake of NSAIDs, 2nd group — with a 2-week continuous course of NSAIDs.Results. There was a positive dynamics of pain syndrome according to VAS and decrease in the level of the WOMAC index in both groups after 2 weeks of therapy. The pain level (VAS) and WOMAC indices in 1st group achieved after 8 weeks significantly differed from the ones after 2 weeks of therapy (VAS dynamics —10.93±2.43 mm, t = 42.64; p<0.001). In both groups we noted gradual significant increase in the average pain level according to VAS and WOMAC indices after NSAIDs cancellation. However, there was better control of pain in 1st group with long-term NSAID than in 2nd one. Safety profile of drug therapy was similar in both groups.Conclusion. The long-term 8-week use of NSAIDs in patients with knee osteoarthritis with insufficient efficacy “on demand” NSAIDs and SYSADOA provides better dynamics of the pain syndrome than with 2-week therapy. After treatment is canceled longer prior NSAID therapy contributes to better control of the pain syndrome. Continuous use of NSAIDs demonstrated good tolerance and safety, did not require dose reduction and/or discontinuation of therapy. Thus, anti-inflammatory therapy of osteoarthritis in this group of patients may be prescribed for a longer period with continuous use of NSAIDs.

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