Comparative Effects of Diclofenac Sodium and Sodium Hyaluronate on Inflammatory Cytokines in Synovial Fluid of Osteoarthritis Patients

The aim of this study was to investigate the effects of diclofenac sodium (DS) and sodium hyaluronate (SH) on synovial fluid cytokines (IL-6, IL-8, VEGF, and TNF-alpha) in the treatment of knee osteoarthritis (OA). A total of 180 patients with OA from November 2018 to October 2019 were selected as the research subjects and divided into two groups as DS and SH groups with n = 90 each. All the volunteers were given injection of DS and SH as per group and synovial fluid extracted before the injection,1 month and 3 months after the injection. The level of IL-6, IL-8, VEGF, and TNF-alpha were determined by biochip array using dedicated evidence instrumentation and software followed by the implement of correlation analysis. Microarray tests performed were used to evaluate the effects of NSAIDs on Tumor necrosis factor (TNF)-alpha, Interleukin-6 (IL-6), IL8 and vascular endothelial growth factor (VEGF) concentration in the synovial fluid. After 3 months of treatment, the efficacy and the effect on patient's gender, age, body mass index (BMI), swollen joint degrees, involved joint space, K-L grading as well as tibiofemoral angle were observed and studied. A statistically significant decrease in the IL-6, VEGF and TNF-alpha concentration in the synovial fluid was observed for both drugs however mathematically HS decreases SF cytokines more than DS. Overall effectiveness rate was 76% and 69% for HS and DS respectively. The change of stromal cell-derived factor-1 (SDF-1) was positively correlated with IL-6, VEGF and TNF-alpha (r = 0.442, P < 0.05; r = 0.410, P < 0.05; r = 0.354, P < 0.05). HA can effectively reduce the level of IL-6, VEGF and TNF-alpha in synovial fluid than DS and inhibit or decrease inflammatory reaction. DS and HS treatment improves the patient disease-specific discomfort with aparallel decrease in pro-inflammatory synovial fluid cytokine levels in knee OA.