Low-dose Spironolactone: Treatment for Osteoarthritis-related Knee Effusion. A Prospective Clinical and Sonographic-based Study

Elsaman, Ahmed M.; Radwan, Ahmed; Mohammed, Walaa; Ohrndorf, Sarah

doi:10.3899/jrheum.151200

Cited by 10 publications

(8 citation statements)

References 25 publications

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“…In patients with OA, low-dose spironolactone improved joint effusion and its associated pain with a higher efficacy than ibuprofen, a commonly used NSAID 209 . Remarkably, lowdose spironolactone (25mg daily) did not affect blood pressure in normotensive individuals 209 , implying that this treatment might also be useful in normotensive OA patients. A large-scale clinical study is still needed to further investigate the efficacy of this treatment.…”

Section: [H2] Potassium-sparing Diureticsmentioning

confidence: 97%

Hypertension meets osteoarthritis — revisiting the vascular aetiology hypothesis

et al. 2021

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Osteoarthritis (OA) is a whole-joint disease characterized by subchondral bone perfusion abnormalities and neovascular invasion into the synovium and articular cartilage. In addition to local vascular disturbance, mounting evidence suggests a pivotal role for systemic vascular pathology in the aetiology of OA. This Review outlines the current understanding of the close relationship between high blood pressure (hypertension) and OA at the crossroads of epidemiology and molecular biology. As one of the most common comorbidities in patients with OA, hypertension can disrupt joint homeostasis both biophysically and biochemically. High blood pressure can increase intraosseous pressure and cause hypoxia, which in turn triggers subchondral bone and osteochondral junction remodelling. Furthermore, systemic activation of the renin-angiotensin and endothelin systems can affect the Wnt-β-catenin signalling pathway locally to govern joint disease.The intimate relationship between hypertension and OA indicates that endothelium-targeted strategies, including re-purposed FDA-approved anti-hypertensive drugs, could be useful for treating OA.[H1] Introduction Osteoarthritis (OA) is a prevalent disease that affects 500 million people worldwide 1 , and is not only a leading cause of chronic pain and disability in older adults, but is also a risk factor for cardiovascular events and all-cause mortality 2-4 . OA is no longer thought of as a simple wear-andtear problem affecting articular cartilage, but rather as a whole-joint disorder subject to interactions between a variety of local and systemic risk factors. The prevalence of knee OA has doubled since the mid-20th century 5 , alongside expanding populations of older individuals and those with obesity.However, neither ageing nor obesity can entirely explain this phenomenon. Therefore, interest is This is the Pre-Published Version.

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Section: [H2] Potassium-sparing Diureticsmentioning

confidence: 97%

Hypertension meets osteoarthritis — revisiting the vascular aetiology hypothesis

et al. 2021

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“…The theory that pain in osteoarthritis (OA) is due to effusion is not answered in our study 1 . All the patients included in our study initially had effusion on clinical and ultrasound examination 1 .…”

Section: To the Editormentioning

confidence: 82%

“…All the patients included in our study initially had effusion on clinical and ultrasound examination 1 . To prove the theory that pain in OA had been due to effusion, we would have had to include patients with painful osteoarthritic knee and examine all of them by ultrasound to detect the cause of pain.…”

Section: To the Editormentioning

confidence: 99%

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et al. 2016

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“…The VAS score was graded from 0 to 10. Grade 0 means no pain and 10 denotes the worst possible pain [12][13][14]. Significant pain relief was defined as 50% improvement or more [15][16][17][18] or a VAS score of 0.…”

Section: Outcome Measures 1) Vas Scorementioning

confidence: 99%

Ultrasound-guided epidural block in axial spondyloarthritis patients with limited spine mobility: a randomized controlled trial

2021

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Low-dose Spironolactone: Treatment for Osteoarthritis-related Knee Effusion. A Prospective Clinical and Sonographic-based Study

Abstract: Low-dose spironolactone is a safe and effective medical treatment for OA-related knee effusion.

Cited by 10 publications

References 25 publications

Hypertension meets osteoarthritis — revisiting the vascular aetiology hypothesis

Hypertension meets osteoarthritis — revisiting the vascular aetiology hypothesis

Dr. Elsaman, et al reply

Ultrasound-guided epidural block in axial spondyloarthritis patients with limited spine mobility: a randomized controlled trial

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