The Cognitive Cytokine Effect of Nonsteroidal Antiinflammatory Drugs in the Treatment of Elderly Patients with Osteoarthritis

Abstract

The goal of this study was to evaluate the effect of long-term nonsteroidal antiinflammatory drug (NSAID) therapy on the severity of cognitive deficiency in elderly patients with osteoarthritis (OA) and the relationship between this effect and cytokine fluctuations in the blood serum of the patients. This prospective observational study took 540 ± 5.5 days and was conducted in two stages: phase I consisted of active medication therapy based on NSAIDs, and phase II was connected with nonpharmacological OA management. A cohort of 128 OA patients aged 65–75 years (the mean age was 70 ± 4.6 years, 10.2% men and 89.8% women) participated in the study. Patients from the main group were divided into four subgroups: the first group (n = 30) received etoricoxib at a daily dose of 60 mg, the second group (n = 32) took celecoxib at a daily dose of 200 mg, the third group (n = 32) was given a daily 100-mg dose of nimesulid, and the patients of the fourth group (n = 34) took meloxicam at a daily dose of 7.5 mg. The control group was formed of 40 patients with OA having analogous clinical and demographic characteristics and not taking NSAIDs in the previous six months and in the course of the study. The initial stiffness and pain indices were measured in all patients by the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) subscales, while their condition was evaluated during all visits to the clinic by the Montreal Cognitive Assessment (MoCA) Scale along with laboratory investigations for the blood serum contents of Transforming Growth Factor (TGF)-β1, Interleukin (IL)-1β, and IL-6. Statistically significant decreases in the levels of cytokines were recorded in the period from the first to the third visits in all patients of the main group, as were increases in the indices of cognitive functions by the MoCA scale with a high degree of correlation relative to the cytokine indicators were observed by the end of the study. The results of the study have allowed us to suggest that the NSAID therapy may have an effect on the cognitive functions of elderly patients with OA in real clinical practice.