biphenylylacetic-acid and Sprains-and-Strains

Musculoskeletal disorders such as soft tissue injuries have traditionally been treated with oral NSAIDs, despite the significant side-effects associated with their clinical use. However, four separate multicentre, double-blind, double-dummy clinical trials have shown that the efficacy of the topical NSAID, felbinac, is equivalent to that of the oral NSAID, ibuprofen, in the treatment of soft tissue injuries, and to that of oral ibuprofen or fenbufen in mild to moderate osteoarthritis. In general practice the incidence of side-effects with felbinac is low, while oral NSAIDs have been associated with significant problems, particularly in the gastrointestinal system. Consequently, the cost of treating side-effects is reduced with felbinac treatment compared with oral NSAIDs, making it a logical treatment alternative from an economic view point as well as for reasons of efficacy and safety.

Topics: Administration, Oral; Administration, Topical; Anti-Inflammatory Agents, Non-Steroidal; Clinical Trials as Topic; Cost-Benefit Analysis; Double-Blind Method; Humans; Knee Joint; Neck Injuries; Osteoarthritis; Phenylacetates; Phenylbutyrates; Sprains and Strains; Treatment Outcome

In the treatment of acute soft tissue injuries, topical nonsteroidal anti-inflammatory drugs are both highly effective and well tolerated. Target is a monopreparation that meets the demands made on a modern topical agent. The active substance, felbinac, readily, penetrates into the tissue affected and accumulates locally, selectively inhibiting inflammation and alleviating pain. This synoptic report on the clinical trials confirm the significant clinical superiority of felbinac over placebo. As compared with piroxicam, felbinac, is more successful in eliminating symptoms. The rapid alleviation of pain by the topical felbinac results in an improvement in the restriction of mobility and rapid restitution of function. The cooling, nongreasy gel base further favors the high level of acceptance of this well-tolerated preparation.

Topics: Administration, Topical; Adolescent; Adult; Aged; Anti-Inflammatory Agents; Athletic Injuries; Child; Contusions; Double-Blind Method; Female; Gels; Humans; Male; Middle Aged; Phenylacetates; Pilot Projects; Sprains and Strains

External medication that is absorbed percutaneously may be used to reduce inflammation and relieve pain from acute injuries such as ankle sprains and bruises. The plaster method of percutaneous absorption for non-steroidal anti-inflammatory drugs (NSAIDs) was established in Japan in 1988. However, due to the possibility of a placebo effect, the efficacy of this method remains unclear. This experimental study was conducted to control for the placebo effect and to study the efficacy of the plaster method in relieving pain by using a rat model of inflammation.. Male Wistar-Imamichi rats were used. A yeast suspension was injected into the right hind paw to induce inflammation. A sheet (2.0 x 1.75 cm) containing the drug was adhered to the inflamed paw. Five treatment groups were used, and each sheet contained a single drug: loxoprofen sodium (loxoprofen-Na) (2.5 mg); felbinac (1.75 mg); indomethacin (1.75 mg); ketoprofen (0.75 mg); or base only (control, 0 mg). Mechanical pain threshold, expression of c-Fos in the dorsal horn, and amount of prostaglandin (PG) E2 in the inflamed paw were evaluated.. Pain threshold increased after treatment, and was significantly increased in the loxoprofen-Na group compared with the control group (p < 0.05). Amounts of PGE2 were significantly decreased in the loxoprofen-Na and indomethacin groups compared with the control group (p < 0.05). Expression of c-Fos was significantly decreased in the loxoprofen-Na group compared with the control group (p < 0.05).. Percutaneously absorbed NSAIDs have an analgesic effect, inhibit expression of c-Fos in the dorsal horn, and reduce PGE2 in inflamed tissue, indicating the efficacy of this method of administration for acute inflammation and localized pain.

Topics: Acute Disease; Administration, Topical; Animals; Anti-Inflammatory Agents, Non-Steroidal; Contusions; Dinoprostone; Indomethacin; Inflammation; Ketoprofen; Male; Pain; Pain Threshold; Phenylacetates; Phenylpropionates; Proto-Oncogene Proteins c-fos; Rats; Rats, Wistar; Sprains and Strains

Non-steroidal anti-inflammatory drugs (NSAIDs) have been shown to be effective in the treatment of acute soft tissue injuries. However, taken orally, NSAIDs have a definite incidence of gastro-intestinal toxicity. Since acute soft tissue trauma is normally localised, use of a topical NSAID may eliminate this undesirable side-effect. This study was designed to evaluate the efficacy and safety of a topical NSAID, biphenylacetic acid 3% gel (Traxam) in the treatment of soft tissue trauma. Thirty-two patients (22 males and 10 females) with acute soft tissue trauma were enrolled at the Department of Orthopaedic Surgery, National University Hospital, Singapore from 7 June 1988 to 28 March 1989. Each patient was treated for a period of one week with bipenylacetic acid 3% gel (Traxam), 60 mg three times a day. Statistically significant improvement was found in pain, swelling and functional impairment in all patients assessed at day 3 and day 7 after the injury. The speed of recovery was enhanced. The medication was found to be well tolerated and safe.

Topics: Administration, Topical; Adolescent; Adult; Anti-Inflammatory Agents, Non-Steroidal; Contusions; Female; Gels; Humans; Male; Middle Aged; Phenylacetates; Sprains and Strains