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Effect of corticosteroids on articular cartilage: have animal studies said everything?

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Vandeweerd, Jean-Michel [UNamur] Zhao, Yang Nisolle, Jean-François [UCL] Zhang, Wenhui Zhihong, Liu [UCL] Gustin, Pascal

Intra-articular (IA) corticosteroids (CS) have been used in the treatment of osteoarthritis for many years, although their effects on articular cartilage are not fully understood. To identify whether previous animal studies have provided enough evidence about the effects of CS, we undertook a systematic review that identified 35 relevant in vivo animal experimental studies between 1965 and 2014 assessing the effects of CS on either normal cartilage, or in either induced osteoarthritis (OA) or synovitis. The quality of the methodology was assessed. Deleterious effects, both structural and biochemical, have mainly been reported in rabbits and are associated with frequent administration of CS, sometimes at high dose and with systemic side effects. In dogs, four identified studies concluded that there were beneficial effects with methylprednisolone acetate (MPA) and triamcinolone hexacetonide therapy. In horses, MPA was mostly deleterious, while triamcinolone acetonide had positive effects in one study highly rated at quality assessment. However, many methodological weaknesses have been identified, such as the lack of pharmacokinetic and pharmocodynamics data and the large variation in doses between studies, the limited selection criteria at baseline, the absence of blinding, and the lack of statistics or appropriate controls for testing the effects of the vehicle of the drug. Those methodological weaknesses weaken the conclusions of numerous studies that assess beneficial or deleterious effects of CS on articular cartilage. Animal studies have not yet provided definitive data, and further research is required into the role of CS in articular pathobiology.

Document type Article de périodique (Journal article) – Article de recherche
Access type Accès restreint
Publication date 2015
Language Anglais
Journal information "Fundamental and Clinical Pharmacology" - Vol. 29, no. 5, p. 427-438 (2015)
Peer reviewed yes
Publisher Wiley-Blackwell Publishing Ltd. ((United Kingdom) Oxford)
issn 0767-3981
e-issn 1472-8206
Publication status Publié
Affiliations UCL - (MGD) Service de radiologie - résonance magnétique
UCL - SSS/IREC/IMAG - Pôle d'imagerie médicale
Keywords Anti-inflammatories ; Articulation ; Joint ; Osteoarthritis
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Bibliographic reference Vandeweerd, Jean-Michel ; Zhao, Yang ; Nisolle, Jean-François ; Zhang, Wenhui ; Zhihong, Liu ; et. al. Effect of corticosteroids on articular cartilage: have animal studies said everything?. In: Fundamental and Clinical Pharmacology, Vol. 29, no. 5, p. 427-438 (2015)
Permanent URL http://hdl.handle.net/2078.1/165371