The effect of non-steroidal anti-inflammatory drugs on the endothelial function of patients with osteoarthritis in short term.

Objective: Our primary aim was to test whether non-steroid anti-inflammatory drug (NSAID) use may account for endothelial dysfunction (ED) in the acute period. Additionally, we also aimed to compare the effect of diclofenac and naproxen on endothelial function.

Methods: Forty patients with osteoarthritis (OA) were included in the study. Subjects currently receiving NSAIDs were asked to discontinue their anti-inflammatory medications (for at least 5 days) before the study. After the wash-out period, all subjects underwent vascular ultrasound measurements. Following baseline vascular imaging, patients were randomly assigned in a 1 : 1 ratio to receive either diclofenac (75 mg twice daily, n = 20), or naproxen (500 mg twice daily, n = 20) for 7 days. Endothelial function was evaluated by using the flow-mediated dilatation (FMD) method, at baseline, and after 1 week of NSAID treatment.

Results: There were 40 OA patients (4 male, 36 female). The median age of the patients was 60 ± 14 years. There were equal numbers of subjects in each treatment group. Age, sex distribution, body mass index, serum lipids, erythrocyte sedimentation rate, C-reactive protein and fasting glucose levels were similar between the diclofenac and naproxen groups (P > 0.05). The brachial artery diameter (BAD), endothelium-dependent vasodilatation (FMD%) and nitroglycerin-induced endothelium-independent vasodilatation (NTG%) values were not different between pretreatment and on the seventh day in the NSAID treatment groups (P > 0.05). Subgroup analysis also showed similar values of BAD, FMD%, and NTG% between naproxen and diclofenac groups (P > 0.05).

Conclusion: Our results suggest that nonselective cyclo-oxygenase antagonists naproxen and diclofenac have no effect on endothelial function during short-term use.