Etodolac: Efficacy in osteoarthritis and effects on chondrocyte function

Abstract

Some nonsteroidal anti-inflammatory drugs (NSAIDs) used in the treatment of osteoarthritis (OA) may damage articular cartilage. This damage may be caused by suppression of proteoglycan synthesis or by altered collagen synthesis in the presence of prostaglandin E2 (PGE2) induced by interleukin-1 (IL-1). The clinical and biochemical effects of etodolac, a new NSAID, on the symptoms of OA and on cartilage metabolism are reviewed. Clinically, etodolac (200-600 mg/day) was more effective than placebo, and as effective as aspirin (3200-4800 mg/day), piroxicam (20 mg/day), naproxen (1000 mg/day), and diclofenac (150 mg/day) in relieving the symptoms of OA. In in vitro studies, proteoglycan synthesis was not affected by the presence of etodolac when human chondrocytes were grown in a three-dimensional culture. Etodolac preserved collagen phenotype in human chondrocytes cultured in a monolayer in the presence of IL-1. In contrast, the collagen phenotype of cells cultured in the presence of indomethacin and IL-1 changed. Under those conditions, less type II and type IX collagen were synthesized and more type I and type III collagen were synthesized. These findings suggest that etodolac, an effective agent in the treatment of OA, has the potential advantage of not damaging articular cartilage in vivo.

Assessment of the efficacy and safety of Etodolac in combined treatment of patients with knee osteoarthrosis

“…Таким чином, нині перевагу віддають препаратам проміжної групи, які мають помірну селективність відносно ЦОГ-2. Вони характеризуються меншою активністю щодо «фізіологічної» ЦОГ-1, ніж неселективні НПЗП, що скорочує ризик гастроінтестинальних ускладнень, але водночас мають кращий кардіоваскулярний профіль безпеки, ніж селективні інгібітори ЦОГ-2 [5,9]. Відомим лікарським засобом цієї проміжної групи є етодолак, представлений на українському ринку препаратом Етол Форт («Нобель»).…”

Randomized Controlled Trial of Etodolac versus Combination of Etodolac and Eperisone in Patients of Knee Osteoarthritis

“…It also inhibits generation of active oxygen species and bradykinin formation in a concentration-dependent manner [5]. Etodolac has the potential advantage of not damaging articular cartilage in vivo [6] and it has a good safety profile [7]. Recommended dose is 200–400 mg 3-4 times/day (doses more than 1000 mg/day are not well tested in clinical trials).…”