The effect of robenacoxib on the concentration of C-reactive protein in synovial fluid from dogs with osteoarthritis
David BennettP.D. EckersallMary WaterstonVeronica MarchettiAlessandra RotaEilidh McCullochSilvia Sbrana
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Robenacoxib is a novel and highly selective inhibitor of COX-2 in dogs and cats and because of its acidic nature is regarded as being tissue-selective. Thirty four dogs with stifle osteoarthritis secondary to failure of the cranial cruciate ligament were recruited into this study. Lameness, radiographic features, synovial cytology and C-reactive protein concentrations in serum and synovial fluid were assessed before and 28 days after commencing a course of Robenacoxib at a dose of 1 mg/kg SID. There was a significant reduction in the lameness score (P < 0.01) and an increase in the radiographic score (P < 0.05) between pre- and post-treatment assessments. There was no difference between pre- (median 1.49 mg/l; Q1-Q3 0.56-4.24 mg/L) and post – (1.10 mg/L; 0.31-1.78 mg/L) treatment serum C-reactive protein levels although synovial fluid levels were significantly reduced (pre- : 0.44 mg/L; 0.23-1.62 mg/L; post- : 0.17 mg/L; 0.05-0.49 mg/L) (P < 0.05). There was no correlation between C-reactive protein concentrations in serum and matched synovial fluid samples. Robenacoxib proved effective in reducing lameness in dogs with failure of the cranial cruciate ligament and osteoarthritis of the stifle joint. The drug also reduced levels of C-reactive protein in the synovial fluid taken from the affected stifle joint. Robenacoxib appears to reduce articular inflammation as assessed by C-reactive protein which supports the concept that Robenacoxib is a tissue-selective non-steroidal anti-inflammatory drug.We aimed to determine whether hand OA is characterized by systemic cartilage loss by assessing if radiographically normal joints had greater joint space width (JSW) loss over 4 years in hands with incident or prevalent OA elsewhere in the hand compared with hands without OA. We used semi-automated software to measure JSW in the distal and proximal IP joints of 3368 participants in the Osteoarthritis Initiative who had baseline and 48-month hand radiographs. A reader scored 16 hand joints (including the thumb base) for Kellgren-Lawrence (KL) grade. A joint had OA if scored as KL ≥2. We identified three groups based on longitudinal hand OA status: no hand OA (KL <2 in all 16 joints) at the baseline and 48-month visits, incident hand OA (KL <2 in all 16 joints at baseline and then one or more joints with KL ≥2 at 48 months) and prevalent hand OA (one or more joints with KL ≥2 at baseline and 48 months). We then assessed if JSW in radiographically normal joints (KL 0) differed across these three groups. We calculated unpooled effect sizes to help interpret the differences between groups. We observed small differences in JSW loss that are unlikely to be clinically important in radiographically normal joints between those without hand OA (n = 1054) and those with incident (n = 102) or prevalent hand OA (n = 2212) (effect size range -0.01-0.24). These findings were robust when examining JSW loss dichotomized based on meaningful change and in other secondary analyses. Hand OA is not a systemic disease of cartilage.
Interphalangeal Joint
Arthropathy
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Objective To examine Expression of CTX-II of the synovial fluid in knee joint osteoarthritis(KOA) and its clinical significance.Methods Eighty patients diagnosised with KOA and another twenty patients diagnosised without osteoarthritis were also selected.These eighty patients with KOA were classified into four groups:moderate,severe,very severe,extremely severe.The CTX-II level in the synovial fluid were measured by Enzyme Linked Immunossassy Assay(ELISA).Results ①The CTX-II level of KOA patients were higher than control group(p0.05);②The CTX-II level of KOA patients increased with the aggravation of degeneration(extremely severevery severeseveremoderate);③There was significant correlation between the expression of CTX-II and the severity of KOA(p0.05).Conclusions The CTX-II level in the synovial fluid increased with the aggravation of degeneration,which can be used to predict the development of KOA.
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Degeneration (medical)
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Objective To investigate expression and significance of ADAMTS-4 in synovial fluid of knee osteoarthritis.Method Among 87 patients with single-side knee osteoarthritis,45 of them suffered from early-stage knee osteoarthritis,and 42 of them from medium-later-stage knee osteoarthritis.The levels of ADAMTSs in synovial fluid of patitents were determined.30 healthy volunteers were selected into the control group.Results ADAMTSs-4 in synovial fluid had higher expression in the early stage OA group than in the late stage OA group(P0.05).Only a few ADAMTS-4 in synovial fluid were expressed in the control group.Conclusion ADAMTS-4 in synovial fluid have high expression in the early stage and late stage OA groups,and ADAMTS-4 has value in the early diagnosis of OA.
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Purpose of review We discuss recent published epidemiologic data regarding risk factors for incident and progressive knee osteoarthritis and related knee pain to identify targets for primary and secondary prevention. We also discuss recently identified methodologic challenges to the study of knee osteoarthritis, particularly osteoarthritis progression. Recent findings Recent epidemiologic studies and systematic reviews of knee osteoarthritis have confirmed that being overweight and obese, and knee injuries increase the risk for incident knee osteoarthritis. Biomechanical risk factors such as leg-length inequalities and malalignment require further study. Obesity also appears to play a role in accelerating osteoarthritis worsening. However, with the exception of malalignment, no risk factors for knee osteoarthritis progression have been identified. Novel approaches to the study of knee pain have demonstrated a strong association between structural abnormalities and knee pain, contrary to the 'so-called' structure-symptom discordance, as well as between fluctuations of knee pain with changes in specific structural lesions. A number of methodologic issues, including conditioning on an intermediate stage of disease and depletion of susceptibles may explain, in part, the difficulty in identifying risk factors for knee osteoarthritis. Summary There is strong epidemiologic evidence that being overweight or obese and knee injury are associated with increased risk of developing knee osteoarthritis. Further study is required to confirm associations of leg-length inequality and malalignment with incident knee osteoarthritis. Few new risk factors for progression of knee osteoarthritis have been identified in the past few years. Without such knowledge, secondary prevention of osteoarthritis remains challenging.
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Osteoarthritis (OA) is a developing process with a multifactorial causality in which changes of the synovial fluid characteristics occur. Hypothesis: synovial fluid pH in severe OA is correlated with other patient parameters. Synovial fluid pH from 50 patients with severe OA (knee/hip) was determined. The results were assessed and correlations with the patients antropologic data and biological markers were analyzed. 50 patients (26 knee OA and 24 hip OA) were analyzed. The average synovial fluid pH was 7.35 indicating slightly lower levels than in normal joints. Higher pH values were observed in males, under 60 years, secondary OA, Rh+ and Hbg under 13.5g/dL. Lower pH values were obtained in females, age under 60 years, primary OA, Rh-, Hbg over 13.5g/dL, hypertensive and diabetic patients. The synovial fluid pH may not be an appropriate biomarker for severe OA disease. Some patient variables might be correlated with synovial blood pH.
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Objective To determine interleukin (IL)-17 concentrations in serum and synovial fluid from patients with knee osteoarthritis, and evaluate their correlation with disease severity. Methods Serum and synovial fluid were collected from patients with primary knee osteoarthritis; age- and sex-matched healthy control subjects provided serum samples. This study was conducted retrospectively. IL-17 was quantified by enzyme-linked immunosorbent assay. Osteoarthritis severity and grade were assessed using the Lequesne index and Kellgren and Lawrence (KL) grading system, respectively. Results Serum IL-17 concentrations were significantly higher in patients ( n = 98) than in controls ( n = 50). In the patient group, the synovial fluid IL-17 concentration increased significantly with KL grade and was significantly positively correlated with Lequesne index ( r = 0.6232). Conclusions The synovial fluid IL-17 concentration could represent a useful biochemical marker to reflect knee osteoarthritis severity and progression.
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Objective To observe and discuss the relationship between levels of ADAMTSs in synovial fluid and knee osteoarthritis in serum and the degree of pathological change.Methods Among 87 patients with single-side knee osteoarthritis,45 of them suffered from early-stage knee osteoarthritis,and 42 of them from medium-later-stage knee osteoarthritis.Examined levels of ADAMTSs in synovial fluid and serum.The control group was 30 healthy volunteers.Results Levels of ADAMTSs in synovial fluid and serum in these patients' bodies were higher than those of the control group.As the degree of pathological change becomes increasingly serious,such levels were increased significantly,and there was linear relationship between levels of ADAMTSs in synovial fluid and those in serum.Conclusion Levels of ADAMTSs in synovial fluid and serum in bodies of persons suffering from knee osteoarthritis are increased,and there is close relationship between the degrees of pathological change.Examination of levels of ADAMTSs in synovial fluid and serum facilitates diagnosis at early stage.
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The pathogenesis of Hydroarthrosis in old age is still obscure. It is well known that synovial fluid play an important role for nutrition of articular cartilage. In order to clarify the pathogenesis of osteoarthritis and hydroarthrosis in old age, an attempt has been made by author to determine the total protein levels in synovial fluid of patients with osteoarthritis and hydroarthrosis.1) The total protein levels in synovial fluid of osteoarthritis or hydroarthrosis was approximately 2.8g/dl.2) No relation was found between the total protein levels and the volume of synovial fluid.3) The total protein in the synovial fluid in inflammatory osteoarthritis is higher than that in the non-inflammatory osteoarthritis.
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We investigated the clinical and radiographic disease course of hand osteoarthritis as well as determinants of poor clinical outcome and radiographic progression over a period of six years in 289 patients with hand osteoarthritis. Because these patients had osteoarthritis at multiple joints this enabled us to not only assess the association between progression of osteoarhtiritis in different hand joints groups but also between progression of hand osteoarthritis and osteoarthritis change at the knee. In addition, genetic factors in hand osteoarthritis progression were investigated as well as the influence of illness perceptions. The hand osteoarthritis subsets erosive osteoarthritis and thumb base osteoarthritis are further characterised. In the last part of the thesis the clinimetric properties of a pain score for osteoarthritis and radiographic outcome measures for hand osteoarthritis are evaluated.
Arthropathy
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GENERAL INFORMATION The Definition of Osteoarthritis Epidemiology of Osteoarthritis Pathology of Osteoarthritis Pathogenesis of Osteoarthritis DIAGNOSIS OF OSTEOARTHRITIS Clinical Features of Osteoarthritis Pitfalls in the Diagnosis of Osteoarthritis Synovial Fluid Analysis Radiography of Osteoarthritis Monitoring the Patient with Osteoarthritis THERAPY Nonmedicinal Therapy for Osteoarthritis Pain Systemic Pharmacologic Therapy Local Therapy for OA Pain A Rational Strategy for Selecting the Initial Pharmacologic Agent for the Management of Osteoarthritis Pain Disease-Modifying Drugs for Osteoarthritis (DMOADs) Tidal Irrigation of the Knee Surgical Intervention Index
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