NSAID Treatment in Knee Osteoarthritis

NCT ID: NCT01860833

Last Updated: 2013-05-23

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

90 participants

Study Classification

INTERVENTIONAL

Study Start Date

2010-04-30

Study Completion Date

2011-08-31

Brief Summary

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Central mechanisms may play a role in pain perception during osteoarthritis (OA).Local inflammation (which involves production of pro-inflammatory cytokines such as interleukin (IL) 4 TNF-alpha, IL-6 and IL-8) is considered to be a major source of pain.

Certain therapies that specifically interfere with the expression or actions of pro-inflammatory cytokines have been explored. NSAIDs have analgesic, antipyretic and anti-inflammatory properties and are extensively prescribed for several musculoskeletal disorders. Indeed, the Osteoarthritis Research Society International (OARSI) recently recommended the use of NSAIDs for management of knee and hip OA in symptomatic patients. These drugs have been shown to influence cytokine metabolism in the synovial fluid of OA patients with satisfactory relief of painful osteoarthritic joints.

The aim of the current study was to explore whether NSAID treatment inhibits TNF-alpha, IL-6, IL-8, and VEGF secretion in the synovial fluid of osteoarthritic joints. In particular, diclofenac, ibuprofen and celecoxib were studied. Under the hypothesis that relationships between proinflammatory cytokines and the clinical status of OA patients are possible, we also evaluated the association between the concentration of these molecules in the osteoarthritic knee synovial fluid and the pain and functional status of patients with OA. The effects of NSAIDS on signal transduction pathways in the synovial membrane were also investigated.

Detailed Description

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not desired

Conditions

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Knee Osteoarthritis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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diclofenac 75 mg/day

diclofenac 75 mg once day slow release

Group Type ACTIVE_COMPARATOR

Diclofenac

Intervention Type DRUG

time of treatment 14 days

diclofenac 150 mg/day

diclofenac 75 mg bid

Group Type ACTIVE_COMPARATOR

Diclofenac

Intervention Type DRUG

time of treatment 14 days

ibuprofen 1200 mg/day

ibuprofen 600 mg bid

Group Type ACTIVE_COMPARATOR

Ibuprofen

Intervention Type DRUG

time of treatment 14 days

ibuprofen 1800 mg/day

ibuprofen 600 mg tid

Group Type ACTIVE_COMPARATOR

Ibuprofen

Intervention Type DRUG

time of treatment 14 days

celecoxib 200 mg/day

celecoxib 200 mg once day

Group Type ACTIVE_COMPARATOR

Celecoxib

Intervention Type DRUG

time of treatment 14 days

celecoxib 400 mg/day

celecoxib 200 mg bid

Group Type ACTIVE_COMPARATOR

Celecoxib

Intervention Type DRUG

time of treatment 14 days

Interventions

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Ibuprofen

time of treatment 14 days

Intervention Type DRUG

Celecoxib

time of treatment 14 days

Intervention Type DRUG

Diclofenac

time of treatment 14 days

Intervention Type DRUG

Other Intervention Names

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Brufen celebrex voltaren

Eligibility Criteria

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Inclusion Criteria

Patients eligible for the study were:

* older than 50 years and
* had primary knee OA diagnosed according to the clinical and radiological criteria of the American Rheumatism Association.


* clinical signs of joint inflammation (warmth, swelling or effusion) and
* a disease severity grade 2 or 3 according to the Kellgren-Lawrence classification

Exclusion Criteria

* allergy to NSAIDs,
* progressive serious medical conditions (such as cancer, AIDS or end-stage renal disease),
* history of gastrointestinal ulcer or bleeding,
* a hemoglobin concentration lower than 11.5 g/dL,
* renal diseases (serum creatinine concentration more than 1.2 times the upper limit of the normal range according to the central laboratory definition reference values), or
* liver dysfunction (serum alanine or aspartate transaminase concentrations more than 1.5 times the upper limit of normal range according to the central laboratory definition reference values).
Minimum Eligible Age

50 Years

Maximum Eligible Age

85 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Catanzaro

OTHER

Sponsor Role lead

Responsible Party

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Luca Gallelli

MD

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Luca Gallelli, MD

Role: PRINCIPAL_INVESTIGATOR

University of Catanzaro

Locations

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Department of Orthopedic and Trauma Surgery

Catanzaro, , Italy

Site Status

Countries

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Italy

References

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Gallelli L, Galasso O, Falcone D, Southworth S, Greco M, Ventura V, Romualdi P, Corigliano A, Terracciano R, Savino R, Gulletta E, Gasparini G, De Sarro G. The effects of nonsteroidal anti-inflammatory drugs on clinical outcomes, synovial fluid cytokine concentration and signal transduction pathways in knee osteoarthritis. A randomized open label trial. Osteoarthritis Cartilage. 2013 Sep;21(9):1400-8. doi: 10.1016/j.joca.2013.06.026.

Reference Type DERIVED
PMID: 23973155 (View on PubMed)

Other Identifiers

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LGOG1

Identifier Type: -

Identifier Source: org_study_id

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