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


Professor Nurullah Akkoc, Dokuz Eylul Universitesi, Tip Fakultesi, Ic Hastaliklari ABD, Romatoloji BD, PK 35340, Balcova, Izmir, Turkey. Email:


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.