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Efecto de los medicamentos antiinflamatorios no esteroideos en el curso de la osteoartritis
S Rashad1, P Revell, A Hemingway
1West Middlesex University Hospital.
Lancet (London, England)
|September 2, 1989
Resumen
Los antiinflamatorios no esteroideos (AINE) pueden empeorar la osteoartritis al reducir el flujo sanguíneo. Los AINE potentes como la indometacina aceleraron la pérdida de espacio articular en pacientes con osteoartritis de cadera.
Área de la Ciencia:
- Reumatología Reumatología.
- Farmacología Farmacología.
- La bioquímica es la bioquímica.
Sus antecedentes:
- La osteoartritis (OA) es una enfermedad articular degenerativa caracterizada por la ruptura del cartílago.
- Los medicamentos antiinflamatorios no esteroideos (AINE) se usan comúnmente para controlar el dolor de OA.
- La hipótesis sugiere que los AINE pueden acelerar la progresión de la OA al inhibir las prostaglandinas vasodilatadoras, reduciendo la perfusión articular.
Objetivo del estudio:
- Para investigar si los AINE aceleran la progresión de la osteoartritis.
- Para determinar el efecto de la inhibición de la síntesis de prostaglandinas en la perfusión articular y la progresión de la OA.
- Para comparar los efectos de un inhibidor de la síntesis de prostaglandinas fuerte (indometacina) frente a un débil (azapropazona) en pacientes con OA de cadera.
Principales métodos:
- Estudio prospectivo de 105 pacientes con osteoartritis en espera de una artroplastia de cadera.
- Pacientes tratados con indometacina (inhibidor fuerte) o azapropazona (inhibidor débil).
- Monitoreo del dolor, el espacio radiológico articular y la condición histopatológica de las cabezas femorales extirpadas.
Principales resultados:
- Ambos grupos de tratamiento alcanzaron un punto final fisiopatológico similar en la artroplastia.
- El grupo de indometacina mostró una pérdida de espacio articular más rápida en las caderas afectadas en comparación con las caderas contralaterales.
- El grupo de azapropazona, con prostaglandinas vasodilatadoras sinoviales más altas, experimentó una progresión más lenta y tardó más en alcanzar el punto final.
Conclusiones:
- La potente inhibición de la síntesis de prostaglandinas puede ser perjudicial en el manejo de la osteoartritis de cadera.
- Los AINE que inhiben fuertemente la síntesis de prostaglandinas podrían acelerar la progresión de la osteoartritis al reducir la perfusión articular.
- Los inhibidores más débiles de la síntesis de prostaglandinas pueden ser más apropiados para el manejo de la artrosis de cadera.
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