Effect of corticosteroids on articular cartilage: have animal studies said everything?
Abstract: 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.
© 2015 Société Française de Pharmacologie et de Thérapeutique.
Publication Date: 2015-08-19 PubMed ID: 26211421DOI: 10.1111/fcp.12137Google Scholar: Lookup
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- Journal Article
- Review
- Systematic Review
Summary
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The research article investigates the effects of corticosteroids on cartilage in animals in order to understand their use for treating osteoarthritis. The study reveals inconclusive results due to methodological weaknesses in existing research, and suggests the need for more comprehensive studies.
Objective of the Research
- The study aims to assess the adequacy of previous animal studies in providing information about the effects of corticosteroids (CS) on articular cartilage. This is achieved through a systematic review of relevant in vivo animal experimental studies conducted between 1965 and 2014.
Analysis of Previous Studies
- The review identified 35 relevant studies that examined the effects of corticosteroids on normal cartilage or that associated with either osteoarthritis or synovitis.
- Deleterious effects—both structural and biochemical—were chiefly reported in rabbits, usually linked to frequent administration of corticosteroids, often at high doses and with systemic side effects.
- In dogs, the treatment was found beneficial in four studies, specifically with methylprednisolone acetate (MPA) and triamcinolone hexacetonide therapy.
- In horses, MPA was mostly harmful, while triamcinolone acetonide had positive effects only in one high-quality study.
Assessment of Methodological Quality
- The research identified multiple methodological weaknesses such as the absence of pharmacokinetic and pharmocodynamics data and significant variation in doses between studies.
- The selection criteria at baseline were limited, and there was a lack of blinding. Additionally, statistical analysis was inadequate or non-existent, and appropriate controls for testing the effects of the drug vehicle were missing.
Conclusion
- The beneficial or deleterious effects of corticosteroids on articular cartilage have not been conclusively determined due to these methodological flaws.
- The study concludes that there is a need for further research in this area to develop a definitive understanding of the role of corticosteroids in articular pathobiology.
Cite This Article
APA
Vandeweerd JM, Zhao Y, Nisolle JF, Zhang W, Zhihong L, Clegg P, Gustin P.
(2015).
Effect of corticosteroids on articular cartilage: have animal studies said everything?
Fundam Clin Pharmacol, 29(5), 427-438.
https://doi.org/10.1111/fcp.12137 Publication
Researcher Affiliations
- Integrated Veterinary Research Unit (IVRU), Namur Research Institute for Life Sciences (NARILIS), University of Namur, Rue de Bruxelles 61, 5000, Namur, Belgium.
- Integrated Veterinary Research Unit (IVRU), Namur Research Institute for Life Sciences (NARILIS), University of Namur, Rue de Bruxelles 61, 5000, Namur, Belgium.
- Shanghai Jiaotong University, School of Medicine, 280, South Chongqing road, 200025 Shanghai, China.
- Service de Pharmacologie-Pharmacothérapie-Toxicologie, Département des Sciences Fonctionnelles, Faculté de Médecine Vétérinaire, Université de Liège, Boulevard de Colonster B41, B-4000 Liège, Belgique.
- Département d'imagerie médicale, Centre Hospitalier Universitaire Mont Godinne-Dinant, Avenue Docteur Gaston-Therasse 1, 5530 Yvoir, Belgique.
- Shanghai Jiaotong University, School of Medicine, 280, South Chongqing road, 200025 Shanghai, China.
- Département d'imagerie médicale, Centre Hospitalier Universitaire Mont Godinne-Dinant, Avenue Docteur Gaston-Therasse 1, 5530 Yvoir, Belgique.
- Orthopaedics Department, Ruijin Hospital, Shanghai Jiaotong University, School of Medicine, 197, Rui Jin Er Road, 200025 Shanghai, China.
- Department of Musculoskeletal Biology, Faculty of Health and Life Sciences, University of Liverpool, Leahurst Campus, CH64 7TE Neston, UK.
- Service de Pharmacologie-Pharmacothérapie-Toxicologie, Département des Sciences Fonctionnelles, Faculté de Médecine Vétérinaire, Université de Liège, Boulevard de Colonster B41, B-4000 Liège, Belgique.
MeSH Terms
- Adrenal Cortex Hormones / administration & dosage
- Adrenal Cortex Hormones / adverse effects
- Adrenal Cortex Hormones / pharmacokinetics
- Animals
- Cartilage, Articular / drug effects
- Cartilage, Articular / metabolism
- Cartilage, Articular / pathology
- Disease Models, Animal
- Dogs
- Horses
- Humans
- Injections, Intra-Articular
- Osteoarthritis / diagnosis
- Osteoarthritis / drug therapy
- Osteoarthritis / metabolism
- Rabbits
- Risk Assessment
- Treatment Outcome
Grant Funding
- MR/K006312/1 / Medical Research Council
Citations
This article has been cited 10 times.- Sabbieti MG, Marchegiani A, Sufianov AA, Gabai VL, Shneider A, Agas D. P62/SQSTM1 beyond Autophagy: Physiological Role and Therapeutic Applications in Laboratory and Domestic Animals. Life (Basel) 2022 Apr 6;12(4).
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- Alves JC, Santos A, Jorge P, Lavrador C, Carreira LM. A Pilot Study on the Efficacy of a Single Intra-Articular Administration of Triamcinolone Acetonide, Hyaluronan, and a Combination of Both for Clinical Management of Osteoarthritis in Police Working Dogs. Front Vet Sci 2020;7:512523.
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- Wang SZ, Wu DY, Chang Q, Guo YD, Wang C, Fan WM. Intra-articular, single-shot co-injection of hyaluronic acid and corticosteroids in knee osteoarthritis: A randomized controlled trial. Exp Ther Med 2018 Sep;16(3):1928-1934.
- Barton KI, Heard BJ, Chung M, Sevick JL, Martin CR, Achari Y, Frank CB, Shrive NG, Hart DA. Location and gene-specific effects of methylprednisolone acetate on mitigating IL1β-induced inflammation in mature ovine explant knee tissue. Inflamm Res 2017 Mar;66(3):239-248.
- El-Azzazi FE, Elnesr SS, Ibrahim IMM, Ali AA. Influence of short-term dexamethasone-induced stress on behavioral, physiological and reproductive performance of growing rabbit bucks. BMC Vet Res 2026 Jan 3;22(1):45.
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