EFFECT OF A NONSTEROIDAL ANTIINFLAMMATORY DRUG ON SYNOVIAL-FLUID IN OSTEOARTHRITIS

Objective. The use of nonsteroidal antiinflammatory drug (NSAID) thera py in osteoarthritis (OA) is controversial because of suggestions that pure analgesics can be as effective as NSAID for pain relief. In addi tion, there is incomplete information whether antiinflammatory effects have any longterm benefit in OA. NSAID have been known to affect syno vial fluid (SF) prostaglandins in rheumatoid arthritis. We describe th e first examination of the effect of an NSAIB, etodolac, on SF prostag landins, cytokines, and cells in OA. Methods. Joint fluids were studie d before and 2 weeks after initiation of therapy with etodolac 400 mg tid. Leukocyte counts, prostaglandin, interleukin 6, and tumor necrosi s factor were measured. Results. Pretreatment features of SF did not p redict clinical response. We found no change in the relatively low leu kocyte counts. However, SF prostaglandin levels and interleukin 6 leve ls were significantly decreased and tumor necrosis factor alpha levels were increased after therapy with NSAID. Conclusion. This NSAID had p otentially important local effects that could be either beneficial or deleterious. Further studies on effects of this and other NSAID on a b roader variety of SF and synovial cytokines may help predict longterm effects of NSAID on progression of OA.