Influence of non-steroidal anti-inflammatory drugs on the inflammatory sonographic features in erosive hand...

The aim was to examine whether inflammatory US features in erosive hand OA patients change when discontinuing intake of NSAIDs before US examination in a non-randomized study.

Patients (n = 99) were allocated to the NSAIDs or control group according to their intake at baseline. US was performed at baseline (T0) and 2 weeks after discontinuation of NSAIDs (T1). Inflammatory features (i.e. synovial proliferation, effusion and power Doppler signal) were scored using a semi-quantitative scale (from zero to three). Pain levels were scored on a numerical rating scale. Binomial mixed models were fitted for US features, and odds ratios of having a US score of at least two vs at most one for synovial proliferation and effusion, and zero vs at least one for power Doppler were calculated.

At baseline, both groups [NSAIDs group (n = 47) vs control group (n = 52)] were comparable for numerical rating scale pain, disease duration, number of radiographically affected joints, BMI and US baseline data, but not for age (P = 0.005). At T1, more synovial proliferation and power Doppler signal was seen compared with T0 in the NSAIDs group (P = 0.018 and 0.031, respectively). However, the interaction term time*NSAIDs was not found to be significant for any variable. The numerical rating scale pain at T1 was higher compared with baseline, although statistically non-significant.

No significant changes in inflammatory US features were seen in patients with erosive hand OA after withdrawal of NSAIDs for 2 weeks. This study suggests that an NSAID-free period is not necessary before assessing inflammatory disease activity in erosive hand OA.