title: 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.
authors.affiliation: Integrated Veterinary Research Unit (IVRU), Namur Research Institute for Life Sciences (NARILIS), University of Namur, Rue de Bruxelles 61, 5000, Namur, Belgium.
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Vandeweerd
authors.affiliation: 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.
authors.forename: Yang
authors.initials: Y
authors.lastname: Zhao
authors.affiliation: Département d'imagerie médicale, Centre Hospitalier Universitaire Mont Godinne-Dinant, Avenue Docteur Gaston-Therasse 1, 5530 Yvoir, Belgique.
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Nisolle
authors.affiliation: Shanghai Jiaotong University, School of Medicine, 280, South Chongqing road, 200025 Shanghai, China.
authors.forename: Wenhui
authors.initials: W
authors.lastname: Zhang
authors.affiliation: 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.
authors.forename: Liu
authors.initials: L
authors.lastname: Zhihong
authors.affiliation: Department of Musculoskeletal Biology, Faculty of Health and Life Sciences, University of Liverpool, Leahurst Campus, CH64 7TE Neston, UK.
authors.forename: Peter
authors.initials: P
authors.lastname: Clegg
authors.affiliation: Service de Pharmacologie-Pharmacothérapie-Toxicologie, Département des Sciences Fonctionnelles, Faculté de Médecine Vétérinaire, Université de Liège, Boulevard de Colonster B41, B-4000 Liège, Belgique.
authors.forename: Pascal
authors.initials: P
authors.lastname: Gustin
mesh_terms: D000305:Adrenal Cortex Hormones / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D000818:Animals; D002358:Cartilage, Articular / Q000187:drug effects* / Q000378:metabolism / Q000473:pathology; D004195:Disease Models, Animal; D004285:Dogs; D006736:Horses; D006801:Humans; D007270:Injections, Intra-Articular; D010003:Osteoarthritis / Q000175:diagnosis / Q000188:drug therapy* / Q000378:metabolism; D011817:Rabbits; D018570:Risk Assessment; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones
keywords: anti-inflammatories; articulation; joint; osteoarthritis