Background Renin-angiotensin-aldosterone system (RAAS) has been proposed as a potential target for the treatment of osteoarthritis (OA). In experimental studies, RAAS blockade led to the reduction of inflammation and modulated cartilage metabolism. Recently, a study showed chondroprotective effects of captopril in an animal model of OA . The effects of RAAS blockade on knee OA have never been studied in humans.
Objectives To investigate longitudinal effects of RAAS blockade on knee pain, function, and radiographic progression of knee OA.
Methods For the current analysis we used data from the publically available Osteoarthritis Initiative (OAI) database. We assessed longitudinal data from OAI participants who did not use angiotensin converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARB) on baseline (new user design) and who had radiographically suspected or confirmed knee OA. The evaluated clinical outcomes were WOMAC pain and WOMAC function subcategories. Radiographic progression was assessed using minimal joint space width (mJSW). The outcomes were measured annually from the baseline to year 4 of follow up. We used structural equation modeling to assess the correlations between the trajectories of ACEI/ARB use and WOMAC knee pain, WOMAC knee function, and mJSW. The models were adjusted for potential baseline confounders.
Results A sample of 1796 OAI participants was analyzed. The proportion of ACEI/ARB users rose from 4.7% on year 1 to 15.14% on year 4 of follow up. No associations between ACEI/ARB use and knee pain, function, and knee OA radiographic progression trajectories were found in the analyses both adjusted or non-adjusted for baseline covariates.
Conclusions RAAS system blockade has no influence on knee OA.
Tang Y, Hu X, Lu X. Captopril, an angiotensin-converting enzyme inhibitor, possesses chondroprotective efficacy in a rat model of osteoarthritis through suppression local renin-angiotensin system. Int J Clin Exp Med 2015; 8: 12584–12592.
Disclosure of Interest None declared