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Other arthritis treatments

NSAIDs

Steroidal and non-steroidal anti-inflammatory drugs (NSAIDs) are the most extensively used treatments for arthritis. While NSAIDs have potent anti-inflammatory and pain killing activities these are mostly related to the alleviation of the clinical signs.

While NSAIDs can have a positive role in pain relief, they are not a long-term solution since they do not address the underlying causes of the arthritic disease. NSAIDs have demonstrated high rates of problems in the gastrointestinal tract (Jones et al., 1992) and kidneys (Bergh and Budsberg, 2005). It has been shown in studies that NSAIDs additionally adversely affect; the healing of bone (Harder and An, 2003), cartilage (Obeid et al., 1992), eye (Yanada et al., 2002), ligament (Elder et al., 2002), skin (Grosse et al., 1999), tendon (Langberg et al., 2003), tendon to bone (Cohen et al., 2002) and ulcers (Pearce et al., 2001).

“The number of adverse drug effects associated with NSAID use and reported to the Food and Drug Administration far exceeds any other companion animal drug, with hepatic, renal, GI, hematologic, nervous system, and urinary tract reactions reported most frequently”

Bergh MS and Budsberg SC (2005) J Vet Intern Med 19:633–64

A more complete analysis of the negative effects of NSAIDS on different tissues is set out in the paper ‘NSAIDs can they do more harm than good’ - Download PDF

 

REFERENCES

Bergh MS and Budsberg SC (2005) The Coxib NSAIDs: Potential Clinical and Pharmacologic Importance in Veterinary Medicine. J Vet Intern Med 19:633–64

Cohen DB et al (2002) Traditional non-steroidal anti-inflammatory medications and cyclooxygenase -2 2 inhibitors impair cuff tendon-to-bone healing. American Orthopaedic Society for Sports Medicine 30th Annual Meeting 2004 Abstracts, 20-21

Elder CL, Dahners LE and Weinhold PS (2001), A Cyclooxygenase-2 Inhibitor Impairs Ligament Healing in the Rat. American Journal of Sports Medicine 29(6): 801-805

Grosse M et al. (1999). Grosse M, Kohn B, Nürnberger M, Ungemach FR and Brunnberg L (1999) Clinical efficacy and tolerance of mgiven after surgical repair of ruptured cruciate ligaments in dogs. Kleintierpraxis 44:93-105

Harder AT and An YH (2003) The mechanisms of the inhibitory effects of nonsteroidal anti-inflammatory drugs on bone healing: A concise review. Journal of Clinical Pharmacology 43: 807-815

Jones RD, Baynes, Nimitz CT. Nonsteroidal anti-inflammatory drug toxicosis in dogs and cats: 240 cases (1989–1990). J Am Vet Med Assoc 1992;201:475–477

Langberg H et al (2003), Cyclo-oxygenase 2 mediated prostaglandin release regulates blood flow in connective tissue during mechanical loading in humans, Journal of Physiology 551(2): 683-68

Obeid G et al (1992) Effect of ibuprofen on the healing and remodelling of bone and articular cartilage in the rabbit temporomandibular joint. Journal of Oral Maxillofacial Surgery 50: 843-849

Pearce et al (2003). Effects of aspirin and indomethacin on endothelial cell proliferation in vitro Journal of Gastroenterology and Hepatology 18:1180-1187

Yamada M et al (2002) Topical diclofenac sodium decreases the substance P content of tears, Archives of Ophthalmology 120(1): 51-54