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Clinical efficacy and mechanism of celecoxib in treatment of knee osteoarthritis |
LIANG Hongwei1, YU Lei1, ZHAO Baofeng1, and LIU Yimin2 |
1. The Second Surgical Department, Beijing Municipal Corps Hospital of Chinese People’s Armed Police Force, Beijing 100027, China; 2. Sanlitun Community Healthcare Center, Chaoyang District, Beijing 100600, China |
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Abstract Objective To evaluate the clinical efficacy of celecoxib, one of the nonsteroidal anti-inflammatory drugs(NSAIDs), in the treatment of knee osteoarthritis (KOA) and its effect on the caspase. Methods A total of 80 KOA patients admitted to the Second Department ofBeijing Municipal Corps Hospital of Chinese People’s Armed Police Force from January 2019 to December 2022 wererandomlydivided into control group (treated with low-intensity pulsed ultrasound) and research group (orally treated with celecoxib capsules plus low-intensity pulsed ultrasound) before and 8 weeks after treatment respectively. Visual analogue scale (VAS), Japanese Orthopaedic Association score (JOA) and Western Ontario and McMaster Universities osteoarthritis index (WOMAC) were scored on thepatientsto determine the score of signs and symptomsand calculatethe improvement rate of curative effect, caspase-3 and caspase-9 levels were measured in serum and synovial fluid, and adverse drug reactions were monitored during the treatment. Results The total clinical efficacy rate in research group (90.0%) were notably elevated as compared to the control group (77.5%) (P<0.05). The VAS, JOA and WOMAC in post-treatment of both groups were evidently improved as compared to those in pre-treatment (P<0.01). In comparison with the control group, the VAS, JOA and WOMAC were significantly improved and the caspase-3 and caspase-9 levels in serum and synovial fluid were significantly decreased in research group after the treatment (P<0.05 or P<0.01). The difference in the incidence of adverse reactions between the two groups was not statistically significant during the treatment (P>0.05). Conclusions The efficacy of celecoxib in treating KOA isconfirmed by the inhibition of KOA pathology through downregulation of caspase-3 and caspase-9 expression in serum and synovial fluid, which may be related withits intervention in chondrocyte apoptosis.
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Received: 20 April 2023
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[1] |
中华医学会骨科学分会关节外科学组,中国医师协会骨科医师分会骨关节炎学组,国家老年疾病临床医学研究中心(湘雅医院),等. 中国骨关节炎诊疗指南(2021年版)[J]. 中华骨科杂志, 2021, 41(18):1291-1314.
|
[2] |
Hwang H S, Kim H A. Chondrocyte apoptosis in the pathogenesis of osteoarthritis [J]. Int J Mol Sci, 2015, 16(11): 26035-26054.
|
[3] |
Hochberg M C, Altman R D, April K T, et al. American College of Rheumatology 2012 recommendations for the use of nonpharmacologic and pharmacologic therapies in osteoarthritis of the hand, hip, and knee [J]. Arthritis Care Res (Hoboken), 2012, 64(4): 465-474.
|
[4] |
中华中医药学会骨伤科分会膝痹病(膝骨关节炎)临床诊疗指南制定工作组.中医骨伤科临床诊疗指南·膝痹病(膝骨关节炎)[J]. 康复学报, 2019, 29(3): 1-7.
|
[5] |
Castrejón I, Chua J R, Pincus T. A RheuMetric physician checklist to quantitate levels of inflammation, damage and distress on 0-10 visual analogue scales [J]. Clin Exp Rheumatol, 2017, 35(Suppl 107): S21-S25.
|
[6] |
Okuda M, Omokawa S, Okahashi K, et al. Validity and reliability of the Japanese Orthopaedic Association score for osteoarthritic knees [J]. J Orthop Sci, 2012, 17(6): 750-756.
|
[7] |
Kim M J, Kang B H, Park S H, et al. Association of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) with muscle strength in community-dwelling Elderly with knee osteoarthritis [J]. Int J Environ Res Public Health, 2020, 17(7): 2260.
|
[8] |
陈卫衡. 膝骨关节炎中医诊疗指南(2020年版)[J].中医正骨, 2020, 32(10): 1-14.
|
[9] |
Hwang H S, Kim H A. Chondrocyte apoptosis in the pathogenesis of osteoarthritis [J]. Int J Mol Sci, 2015, 16(11): 26035-26054.
|
[10] |
Qian Z, Ru X, Liu C, et al. Fraxin prevents knee osteoarthritis through inhibiting chondrocyte apoptosis in an experimental rat osteoarthritis model [J]. Protein Pept Lett, 2021, 28(11): 1298-1302.
|
[11] |
许 珂,许 鹏.骨关节炎软骨细胞死亡机制研究[J].中华风湿病学杂志,2011,15(4):271-274.
|
[12] |
Matsuo M, Nishida K, Yoshida A, et al. Expression of caspase-3 and -9 relevant to cartilage destruction and chondrocyte apoptosis in human osteoarthritic cartilage [J]. Acta Med Okayama, 2001, 55(6): 333-340.
|
[13] |
万 超,朱小虎,程宇核,等.内热针疗法对膝骨关节炎大鼠软骨细胞凋亡及Caspase-3和Caspase-9表达的影响[J].中国针灸, 2019, 39(4): 409-416.
|
[14] |
殷 娜,汤锋武,符 锋,等.低强度脉冲聚焦超声联合等速肌力训练对膝骨关节炎患者膝关节本体感觉、生活质量和炎性因子水平的影响[J]. 现代生物医学进展, 2021, 21(22): 4275-4278, 4297.
|
[15] |
任莎莎,李雪萍,林 强,等.低强度脉冲超声经PI3K/Akt通路调控兔膝骨性关节炎软骨细胞凋亡的作用机制研究[J].中国康复,2015,30(2):83-87.
|
[16] |
刘秋红,孔 瑛,李灿阳,等.低强度脉冲超声对大鼠膝骨关节炎软骨细胞内质网应激相关Caspase-12表达的影响[J].中国康复医学杂志,2020,35(10):1172-1180.
|
[17] |
Kim M S, Koh I J, Sung Y G, et al. Efficacy and safety of celecoxib combined with JOINS in the treatment of degenerative knee osteoarthritis: study protocol of a randomized controlled trial [J]. Ther Adv Musculoskelet Dis, 2021, 13: 1759720X211024025.
|
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