Abstract

  Osteoarthritis (OA) is the most common form of arthritis, affecting millions of people worldwide. It is an inflammatory, degenerative and progressive disease which worsens over time, resulting in joint pain, swelling and stiffness. As the disease progresses, pain and stiffness become severe making daily tasks difficult, thereby affecting the quality of life. The treatment of osteoarthritis mainly focuses on management of inflammation to control the symptoms as complete reversal of the disease is not practical. Non-steroidal anti-inflammatory drugs (NSAIDs) are most commonly used and are mainstay drugs in the symptomatic treatment of osteoarthritis. Various NSAIDs are currently available in the market and looking into the co-morbidities associated with OA, there is a need for well tolerated NSAID with proven efficacy and safety. Aceclofenac, although was a late entry in crowded NSAID market, but, now is a well established drug in management of OA pain. It predominantly inhibits the inflammatory COX-2 enzyme, and due to less inhibitory action on gastroprotective COX-1 enzyme, it can be categorized as a preferential COX-2 inhibitor. Besides prostaglandin synthesis, it also inhibits synthesis of other inflammatory mediators like interleukins, tumour necrosis factor, nitric oxide and matrix metalloproteinases. This makes its efficacy similar or superior to other NSAIDs. Its efficacy has been evaluated in international studies as well as in Indian patient setting, where it has shown significant decrease in pain and severity of symptoms and improvement of functional capacity in osteoarthritis patients. Additionally, aceclofenac has a unique chondroprotective action and hence exerts a stimulatory effect on cartilage matrix synthesis. Due to preferential COX-2 inhibition, it is well-tolerated amongst the available NSAIDs, with a lower incidence of gastrointestinal and other NSAID related side effects. Good tolerability profile of aceclofenac results in decreased withdrawal rate and greater compliance of the treatment. Aceclofenac is the preferred drug for chronic therapy of osteoarthritis as long term studies highlighting the efficacy and tolerability of the drug are available. This review mainly focuses on the efficacy of aceclofenac, and also briefly mentions its safety in osteoarthritis management

Keywords: Osteoarthritis; NSAIDs; Aceclofenac; Pain; Inflammation COX Inhibitor

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Citation

Citation: Anu Grover., et al. “Aceclofenac in Osteoarthritis - NSAID with Novel Mechanism of Action".Acta Scientific Orthopaedics 3.12 (2020): 02-13.

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Copyright: © 2020 Anu Grover., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.