lornoxicam and Acute-Disease

Lornoxicam is one of the oxicam class of non-steroidal anti-inflammatory drugs (NSAIDs), producing analgesic and antipyretic effects in part through the non-selective inhibition of cyclo-oxygenase-1 and -2. It is prescribed for osteoarthritis, rheumatoid arthritis, acute lumbar-sciatica conditions and for postoperative pain management. Lornoxicam is available in 31 countries in Europe, the Middle East, Far East and South America, and is becoming more widely available.. To assess the efficacy, the time to onset of analgesia, the time to use of rescue medication and any associated adverse events of single dose oral lornoxicam in acute postoperative pain.. We searched CENTRAL, MEDLINE, EMBASE and PubMed to June 2009.. Single oral dose, randomised, double-blind, placebo-controlled trials of lornoxicam for relief of established moderate to severe postoperative pain in adults.. Studies were assessed for methodological quality and the data extracted by two review authors independently. Summed total pain relief over 6 hours (TOTPAR 6) was used to calculate the number of participants achieving at least 50% pain relief. These derived results were used to calculate, with 95% confidence intervals (CIs), the relative benefit compared to placebo, and the number needed to treat (NNT) for one participant to experience at least 50% pain relief over 6 hours. Numbers of participants using rescue medication over specified time periods, and time to use of rescue medication, were sought as additional measures of efficacy. Information on adverse events and withdrawals was collected.. Three studies, with 628 participants, met the inclusion criteria; 434 participants were treated with various doses (2 mg to 32 mg) of lornoxicam, 118 with placebo, and 76 with other active therapies. All the participants had pain following third molar extraction, and study duration was 8 to 24 hours. The NNT for at least 50% pain relief over 6 hours after a single dose of lornoxicam 8 mg was 2.9 (2.3 to 4.0). There were insufficient data to analyse other doses or use of rescue medication. No serious adverse events or withdrawals were reported by any of the studies.. Oral lornoxicam is effective at treating moderate to severe acute postoperative pain, based on limited data. Adverse events did not differ significantly from placebo.

Topics: Acute Disease; Administration, Oral; Adult; Analgesics, Non-Narcotic; Anti-Inflammatory Agents, Non-Steroidal; Humans; Pain, Postoperative; Piroxicam; Randomized Controlled Trials as Topic

Topics: Acute Disease; Analgesics; Analgesics, Opioid; Animals; Anti-Inflammatory Agents, Non-Steroidal; Bite Force; Calcitonin Gene-Related Peptide; Disease Models, Animal; Dose-Response Relationship, Drug; Drug Evaluation; Humans; Mandible; Molar, Third; Morphine; Movement; Neuropeptides; Pain Threshold; Pain, Postoperative; Piroxicam; Rats; Substance P; Tooth Extraction

To assess the effects of the cyclooxygenase-1/cyclooxygenase-2 inhibitor lornoxicam on systemic complications in patients with acute pancreatitis, Toll-like receptor (TLR)2 and TLR4 messenger RNA expression, and cytokine secretion (IL-6, IL-8, tumor necrosis factor-α).. Adult patients with acute pancreatitis were randomized to standard therapy or standard therapy plus lornoxicam. Standard therapy included analgesics, spasmolytics, octreotide, pantoprazole, and intravenous fluids. The TLR2 and TLR4 expression levels and TLR2- and TLR4-mediated cytokine production in peripheral blood mononuclear cells were assessed in patients with severe complications and in healthy volunteers (n = 15).. A total of 334 patients received standard therapy (n = 246) or standard therapy plus lornoxicam (n = 88), 172 (51.5%) of whom developed systemic complications. Occurrence of complications was higher with standard therapy compared with lornoxicam (57.3% versus 35.2%; P = 0.00034), as was mortality (19.1% versus 6.8%; P = 0.006). The TLR2 and TLR4 expression and TLR2 and TLR4-mediated cytokine production were significantly higher in patients with systemic complications of acute pancreatitis compared with healthy volunteers. Relative TLR2 expression and cytokine production were significantly reduced in patients receiving lornoxicam versus standard therapy.. The use of lornoxicam at the onset of acute pancreatitis decreased TLR2 and TLR4 expression and the production of proinflammatory cytokines, thereby reducing the risk of systemic complications and mortality.

Topics: Acute Disease; Adult; Aged; Biomarkers; Cyclooxygenase Inhibitors; Female; Humans; Inflammation Mediators; Interleukin-6; Interleukin-8; Leukocytes, Mononuclear; Male; Middle Aged; Pancreatitis; Piroxicam; Prospective Studies; RNA, Messenger; Russia; Time Factors; Toll-Like Receptor 2; Toll-Like Receptor 4; Treatment Outcome; Tumor Necrosis Factor-alpha

Parenteral non-steroidal anti-inflammatory drugs (NSAIDs) are useful agents in the treatment of postoperative pain and other acute traumatic painful conditions such as fractures. Clinical trials with lornoxicam, an oxicam derivative, document its efficacy as a potent analgesic with excellent anti-inflammatory properties in painful and or/inflammatory conditions including postoperative pain and arthritic conditions. However, there is no documentation of the efficacy and tolerability of intravenous lornoxicam in Indian patients with acute painful conditions such painful traumatic conditions requiring hospitalisation and parenteral analgesics. The present study was undertaken to evaluate the efficacy and tolerability of intravenous lornoxicam in Indian patients with postoperative pain or other acute painful traumatic conditions requiring hospitalisation and parenteral analgesia in in-office practice conditions. In this multicentric, prospective, open, non-comparative phase IV, postmarketing surveillance study patients admitted in the nursing home for either postoperative pain or painful conditions requiring hospitalisation and parenteral analgesia were enrolled in the study after obtaining their informed consent. Of the 161 patients fulfilling the selection criteria, 148 met the selection criteria and were included in the efficacy analysis. Patients were treated with intravenous lornoxicam 8 mg twice or three times daily as required for up to 3 days. Efficacy variables included changes in severity of pain scores compared to baseline values, onset of pain relief and overall global efficacy. Tolerability was assessed through monitoring of treatment-emergent adverse events, physical examination, assessments of vital signs, and overall global assessment of tolerability. Results indicated that within 1 hour of administration of intravenous lornoxicam, the mean scores of pain severity were reduced by 39.46% and by 6 hours, there was a further 52% reduction in the mean scores. Therapy with intravenous lornoxicam was associated with a faster onset of action with 15.4% patients reporting pain relief within 10 minutes and 55.9% patients within 10 to 30 minutes. Overall, global assessment of efficacy was rated as good to excellent in 95.3% of the patients. Therapy with intravenous lornoxicam was well tolerated with only 5 patients reporting adverse events such as headache (n=3) and gastritis (n=1) of mild to moderate intensity but transient. Overall, global tolerabilit

Topics: Acute Disease; Adolescent; Adult; Aged; Anti-Inflammatory Agents, Non-Steroidal; Female; Humans; Infusions, Intravenous; Male; Middle Aged; Pain; Pain Measurement; Piroxicam; Prospective Studies; Treatment Outcome; Young Adult

68 patients in the age of 32-83 years (middle age 61.83 +/- 14.73 year) with the diagnosis acute odontogenic periostitis of jaw before treatment (at height of acuteness) and on a background of the complex treatment which include Xefocam were examined. It is shown, that treatment with addition of Xefocam accelerates regress of an inflammation and a stage of recovery. High analgetic activity of Xefocam at this pathology was revealed. The greatest efficiency of this drug is marked in group of patients of elderly and senile age. The opportunity of definition the Melatonin concentration in a saliva as marker of speed of inflammatory process regress is shown. The high level of Melatonin concentration in a saliva at peak of an inflammation is significant prognostic criterion of outcome of disease. The high level of Melatonin in saliva at the patients of advanced age who has survived in the childhood the siege of Leningrad in comparison with patients of similar age, who was not exposed in the childhood by multifactor stress impact influence, is revealed more.

Topics: Acute Disease; Adult; Aged; Aged, 80 and over; Anti-Inflammatory Agents, Non-Steroidal; Humans; Jaw Diseases; Melatonin; Middle Aged; Periostitis; Piroxicam; Saliva

We compared the efficacy of intravenous lornoxicam vs. dipyrone in patient-controlled analgesia for postoperative analgesia.. The study included 105 patients who had undergone elective septorhinoplasty after receiving general anaesthesia. Patients were divided into three groups to receive lornoxicam (24 mg day(-1)), dipyrone (5 g day(-1)) or placebo. Pain was evaluated using a 0-100 mm visual analogue scale at 2, 4, 6, 8, 12, 16, 20 and 24 h postoperatively. Pethidine (1 mg kg(-1)) was administered intramuscularly to patients requiring rescue analgesia. Pethidine requirements were recorded during the first 24 h postoperatively, and treatment-related adverse effects were noted.. Postoperative pain scores were significantly lower with lornoxicam compared with dipyrone at 8 h (P = 0.016). No significant differences regarding pain scores at 2, 4, 6, 12, 16, 20 and 24 h were found. Significantly fewer patients in the lornoxicam group required rescue analgesics (vs. dipyrone, P = 0.046; vs. placebo, P = 0.001); fewer patients in the dipyrone group required rescue analgesics compared with placebo (P = 0.008). Significantly fewer patients in the lornoxicam group had nausea (vs. dipyrone, P = 0.022; vs. placebo, P = 0.006); no significant differences were found between the other two groups. Antiemetic use was significantly lower in the lornoxicam group (vs. dipyrone, P = 0.002; vs. placebo, P = 0.001).. Lornoxicam has better tolerability and is a more effective analgesic than dipyrone when administered by patient-controlled analgesia for postoperative analgesia after septorhinoplasty.

Topics: Acute Disease; Adolescent; Adult; Analgesia, Patient-Controlled; Analgesics, Opioid; Anti-Inflammatory Agents, Non-Steroidal; Dipyrone; Double-Blind Method; Elective Surgical Procedures; Female; Humans; Infusions, Intravenous; Male; Meperidine; Middle Aged; Nasal Septum; Pain Measurement; Pain, Postoperative; Piroxicam; Postoperative Nausea and Vomiting; Prospective Studies; Rhinoplasty; Time Factors; Treatment Outcome

NSAIDs are widely used for patients presenting with low back pain. A quick-release formulation of lornoxicam, a potent NSAID from the chemical class of oxicams, offers a faster onset of pain relief compared with the standard tablet formulation.. Time to onset of pain relief with lornoxicam was compared with the quick-release formulation of diclofenac potassium in acute low back pain in a randomised, double-blind, multicentre study. 220 patients received either lornoxicam 24 mg or diclofenac potassium 150 mg on day 1 followed by lornoxicam 8 mg twice daily or diclofenac potassium 50 mg twice daily for 5 days. Efficacy outcomes included time to onset of pain relief, as measured by the stopwatch method (primary outcome), pain intensity, pain relief, rescue medication, ability to perform daily activities and global evaluation of the study medication.. The time to onset of pain relief ratios between diclofenac potassium/lornoxicam was 1.03 (95% CI 0.91, 1.26) and 1.05 (95% CI 0.93, 1.29) in the intention-to-treat (ITT) and per-protocol (PP) analyses, respectively, demonstrating the non-inferiority of lornoxicam (defined by lower limits of the 95% CIs >0.80). Time to onset of pain relief was shorter with lornoxicam (30 minutes) compared with diclofenac potassium (36 minutes). The difference was not statistically significant (ITT analysis). A higher magnitude of analgesic effect associated with better global evaluation of the study medication for lornoxicam was also demonstrated. The drugs were equally well tolerated.. Lornoxicam administered as a quick-release formulation was shown to be non-inferior to the equivalent formulation of diclofenac potassium in terms of onset of pain relief and more effective on most of the major standard efficacy outcomes.

Topics: Abdominal Pain; Acute Disease; Adult; Anti-Inflammatory Agents, Non-Steroidal; Diclofenac; Dizziness; Double-Blind Method; Drug Administration Schedule; Female; Headache; Humans; Low Back Pain; Male; Middle Aged; Pain Measurement; Piroxicam; Severity of Illness Index; Tablets; Time Factors; Treatment Outcome; Urticaria

Topics: Acitretin; Acute Disease; Acute Generalized Exanthematous Pustulosis; Adult; Biopsy, Needle; Female; Follow-Up Studies; Humans; Immunohistochemistry; Low Back Pain; Piroxicam; Psoriasis; Risk Assessment; Withholding Treatment

Transdermal nitroglycerine can improve analgesic effects when used with other analgesics. The aim of the study was to investigate the additive effects of nitroglycerine combined with lornoxicam for acute pain in rats. Thirty-nine Wistar male rats were divided into five groups; Group SF (n=8, saline), Group L-1 (n=8, lornoxicam 1.3 mg/kg), Group L-2 (n=8, lornoxicam 2.6 mg/kg), Group LNO (n=8, nitroglycerine and lornoxicam, 1 mg/kg+1.3 mg/kg), and Group LNO-2 (n=8, nitroglycerine and lornoxicam, 1 mg/ kg+2.6 mg/kg). Tail flick and hot plate tests were measured in all groups before the intraperitoneal injections of drug and 30, 60 and 90 minutes after the injections. Cut-off time was 20 s and 60 s in tail-flick and hot-plate tests. Although there were significant differences between the groups according to hot-plate test at the 30th, 60th and 90th minutes (p<0.05), there was no difference between the groups with tail flick test. The most increasing of latency response in hot-plate assays was seen in Group LNO-1 compared to other groups at the 30th minute (p<0.05). The latency response increased significantly in Group L-1, L-2, LNO-1 and LNO-2 compared with saline group at the 60th and 90th minutes (p<0.05). There were significant differences in latency responses in Group L-1 and Group LNO-1 compared to Group L-2 and Group LNO-2 at the 60th and 90th minutes. In conclusion, 1.3 mg/kg dose of lornoksicam with the use of nitrogliserine provided early and efficient analgesia, but the increasing dose of lornoksicam did not maintain better analgesia.

Topics: Acute Disease; Analgesics; Animals; Anti-Inflammatory Agents, Non-Steroidal; Drug Therapy, Combination; Hot Temperature; Injections, Intraperitoneal; Male; Nitroglycerin; Pain; Pain Measurement; Piroxicam; Rats; Rats, Wistar