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NSAIDs and DMARDS in osteoarthritis: the relation between subchondral bone en cartilage damage in OA

Friday 6 November 2009

Prof.dr Floris Lafeber / dr Simon Mastbergen

Osteoarthritis is a degenerative joint disease that is characterized with progressive damage of the articular cartilage, change in the subchondral bone, osteofytes and possible inflammation of the synovium. A cure does not exist and treatment that is often given to patients with osteoarthritis is non-steroidal anti-inflammatory drugs (NSAIDs) to relieve pain and to inhibit inflammation.

Recent in vitro research has shown that celecoxib, a selective COX-2 inhibitor (second generation NSAIDs), has a positive effect on articular cartilage and possibly even induces cartilage repair. These effects are difficult to investigate in vivo with x-ray or MRI because of the limited sensitivity of these techniques. Therefore we have chosen for an approach that combines an in vivo treatment with the benefits of an ex vivo biochemical analysis of the cartilage.

Not much is known of the changes that take place in the underlying bone. Is there a relation between the changes in the subchondral architecture and the degeneration of cartilage? And can this change be influenced by medication? Questions that we like to see answered. In the material collected in the clinical trial in which knee OA patients are treated with different NSAIDs we will look into the structure of the underlying bone with micro-CT (in collaboration with the Erasmus MC in Rotterdam).
The aim of this stage is to evaluate the relation between the subchondral bone and the cartilage damage and to expand the current results within the trial.

You will contribute to:
- the making of boneplugs from bone collected during the clinical trial
- the scanning of the boneplugs with micro-CT (Erasmus MC Rotterdam)
- the processing of the scanned data with computer analysis (UMCU)
- the further processing of this analysis in Excel and SPSS
- the base of a publication

6 or 9 months

Dr Simon Mastbergen, S.Mastbergen@umcutrecht.nl, 088-755 9758
Prof.dr Floris Lafeber, F.Lafeber@umcutrecht.nl, 088-755 8521