Structural efficacy of NSAIDs, COX-2 inhibitor and glucocorticoid compared with TNFα blocker: a study in adjuvant-induced arthritis rats

Rheumatology (Oxford). 2019 Jun 1;58(6):1099-1103. doi: 10.1093/rheumatology/key444.

Abstract

Objective: To evaluate radiographic outcomes after an early treatment for 21 days with etanercept, naproxen, celecoxib, prednisone or methotrexate in adjuvant-induced arthritis in rats.

Methods: At the onset of arthritis, rats were daily treated with naproxen (10 mg/kg/day i.p.), celecoxib (3 mg/kg/day), prednisolone (10 mg/kg/day), etanercept (10 mg/kg/3 days), methotrexate (2 mg/kg/3 days) or saline solution (vehicle) for 21 days. The arthritis score was daily monitored. At the end of treatment, a hind paw radiographic examination was performed with a BMA high-resolution digital X-ray system (40 mV, 10 mA). A score of 0-20 was determined for each paw. Plasma levels of TNFα were measured.

Results: Compared with vehicle, all treatments reduced (P < 0.001) the arthritis score. All treatments, except methotrexate, slowed radiographic destruction (P < 0.001). All treatments, except etanercept, reduced the plasma level of TNFα. Naproxen, glucocorticoid and celecoxib were more effective than etanercept on the radiographic score (P < 0.01). Naproxen was the only treatment to be more effective on all different radiographic subscores than etanercept.

Conclusion: Our study demonstrated for the first time that an early treatment with NSAIDs, excluding cyclooxygenase-2 selective inhibitor, is more beneficial than a TNFα blocker in preventing structural damage in adjuvant-induced arthritis.

Keywords: NSAIDs; adjuvant-induced arthritis; inflammation; structural damage.

MeSH terms

  • Animals
  • Anti-Inflammatory Agents, Non-Steroidal / pharmacology*
  • Antirheumatic Agents / pharmacology*
  • Arthritis, Experimental / diagnostic imaging
  • Arthritis, Experimental / drug therapy*
  • Celecoxib / pharmacology
  • Cyclooxygenase 2 Inhibitors / pharmacology*
  • Etanercept / pharmacology
  • Glucocorticoids / pharmacology*
  • Hindlimb / diagnostic imaging
  • Hindlimb / drug effects
  • Methotrexate / pharmacology
  • Naproxen / pharmacology
  • Prednisone / pharmacology
  • Rats
  • Treatment Outcome
  • Tumor Necrosis Factor-alpha / antagonists & inhibitors
  • Tumor Necrosis Factor-alpha / blood

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Antirheumatic Agents
  • Cyclooxygenase 2 Inhibitors
  • Glucocorticoids
  • Tumor Necrosis Factor-alpha
  • Naproxen
  • Celecoxib
  • Etanercept
  • Prednisone
  • Methotrexate