Limited effects of non-steroidal anti-inflammatory drugs (NSAIDs) on imaging outcomes in osteoarthritis: observational data from the osteoarthritis initiative (OAI)

Kreutzinger V, et al. · BMC Musculoskeletal Disorders

Over 48 months new NSAID use showed no significant association with effusion-synovitis, Hoffa's synovitis or synovial proliferation. It was associated with significantly slower progression of cartilage lesions on WORMS grading (beta -0.48, p = 0.020), an effect the authors describe as modest and as more pronounced in participants with an inflammatory imaging phenotype. The title's 'limited effects' refers to the synovitis endpoints, not to cartilage.

Population

142 Osteoarthritis Initiative participants meeting prespecified criteria for new prescription NSAID exposure, frequency-matched to 707 non-users on age, sex, BMI and baseline Kellgren-Lawrence grade, with 3T knee MRI at baseline and 48 months

Intervention

Regular NSAID use (observed)

Comparator

Non-users

Limitations

Observational, using a new-user design with frequency matching rather than randomisation, so confounding by indication is not excluded; heterogeneous NSAID types and doses pooled. Funded by NIH grants R01-AG070647, R01-AR064771 and R01-AR078917; the Osteoarthritis Initiative itself is a public-private partnership whose private funding partners are Merck, Novartis, GlaxoSmithKline and Pfizer.