lornoxicam and Low-Back-Pain

Lornoxicam (chlortenoxicam), a new nonsteroidal anti-inflammatory drug (NSAID) of the oxicam class with analgesic, anti-inflammatory and antipyretic properties, is available in oral and parenteral formulations. It is distinguished from established oxicams by a relatively short elimination half-life (3 to 5 hours), which may be advantageous from a tolerability standpoint. Data from preliminary clinical trials suggest that lornoxicam is as effective as the opioid analgesics morphine, pethidine (meperidine) and tramadol in relieving postoperative pain following gynaecological or orthopaedic surgery, and as effective as other NSAIDs after oral surgery. Lornoxicam was also as effective as other NSAIDs in relieving symptoms of osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, acute sciatica and low back pain. Lornoxicam has a tolerability profile characteristic of an NSAID, with gastrointestinal disturbances being the most common adverse events. Limited clinical experience to date suggests that, as with a number of other NSAIDs, lornoxicam may provide a better-tolerated alternative or adjuvant to opioid analgesics for the management of moderate to severe pain. It has also demonstrated potential as an alternative to other NSAIDs for the management of arthritis and other painful and inflammatory conditions. These preliminary findings require confirmation in further comparative and long term studies.

Topics: Absorption; Anti-Inflammatory Agents, Non-Steroidal; Arthritis, Rheumatoid; Dosage Forms; Drug Interactions; Humans; Low Back Pain; Migraine Disorders; Osteoarthritis; Pain; Pain, Postoperative; Piroxicam; Spondylitis, Ankylosing; Tissue Distribution

Low back pain after lumbar epidural anesthesia remains an important clinical problem. Possible causes of the back pain associated with epidural anaesthesia are localized trauma, aseptic periosteitis, tendonitis, inflammation of the ligaments, and osteochondritis. Lornoxicam is a new nonsteroidal anti-inflammatory drug (NSAID) that has been shown to be effective and well tolerated in the treatment of postoperative pain. The use of locally administered lornoxicam for the relief of low back pain following lumbar epidural anesthesia has not yet been studied. Thus, the aim of the present study was to investigate the efficacy of lornoxicam in the management of pain after lumbar epidural anesthesia.. A total of 60 patients were randomized to receive either treatment with lornoxicam or to receive a control treatment. The Lornoxicam group received 12 ml of 0.5% epidural bupivacaine and 4 ml 1% lidocaine, along with 2 mg lornoxicam for local infiltration. The control group received 12 ml of 0.5% epidural and 4 mL 1% lidocaine alone for local infiltration. Following the initial preoperative evaluation, a blinded investigator assessed pain intensity at 24, 48 and 72 hours postoperatively using a Verbal Rating Scale (VRS).. The overall frequency of low back pain after epidural anesthesia was significantly higher in control-group patients compared to Lornoxicam-group patients during the 3 days studied (26.6% and 6.6%, respectively, P<0.05).. Our study demonstrated that local administration of Lornoxicam before epidural anesthesia for pilonidal sinus surgery decreased the frequency and severity of low back pain following lumbar epidural anesthesia with lidocaine. In conclusion, local administration of lornoxicam during epidural anesthesia may present a useful option for the relief of post-epidural low back pain.

Topics: Adult; Anesthesia, Epidural; Anti-Inflammatory Agents, Non-Steroidal; Double-Blind Method; Female; Humans; Low Back Pain; Male; Pain Measurement; Piroxicam; Young Adult

The efficacy and safety of oral lornoxicam (LNX) as early treatment of acute sciatica/lumbo-sciatica was compared with placebo and diclofenac in a 5-day double-blind, randomised study.. Male or female patients (n = 171) aged 18-70 years with acute sciatica or lumbo-sciatica [acute sciatica defined as typical radiation of pain along the sciatic nerve (including radiating pain below the knee) and worsening of pain as defined by Lasegue's leg-raising test (< 60 degrees ) within 72 h and previous attack ceased > 3 months previously; lumbo-sciatica defined as symptoms of sciatica with concurrent lumbar pain and a predefined minimum pain score]. The dosage of study treatment was 8-24 mg/day LNX, 100-150 mg/day diclofenac or placebo. The primary end-point was the difference in pain intensity difference from baseline to 6 h (PID(0-6 h)) after the first dose of study treatment. Secondary end-points were pain relief, the cumulative sums of pain intensity difference and total pain relief on day 1 and on days 2-4.. In total, 164 patients completed the study. Significant differences in PID between LNX and placebo were seen in the time interval 3-8 h after the first dose including PID(0-6 h) (p = 0.015). Secondary end-points favoured LNX vs. placebo, but in general were not significantly different. LNX and diclofenac had similar analgesic effect. Incidence and severity of adverse events were comparable for the three treatments; overall tolerability was rated as very good/good by 93% of the patients.. These data indicate that the analgesic efficacy of LNX is superior to placebo and similar to diclofenac in acute sciatica/lumbo-sciatica.

Topics: Adolescent; Adult; Aged; Anti-Inflammatory Agents, Non-Steroidal; Cyclooxygenase Inhibitors; Diclofenac; Double-Blind Method; Female; Humans; Low Back Pain; Male; Middle Aged; Pain Measurement; Piroxicam; Prospective Studies; Sciatica; Treatment Outcome; Young Adult

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

To evaluate clinical efficacy and tolerability of electrode pharmaphoresis using preparations xefocam and mydocalm-richter in railway workers with low-back pain.. Authors carried out an open prospective noncomparative study of 16 patients, aged 21-82 years, with spinal osteochondrosis with root syndrome and radiculopathia of the lumbar/sacral spine with pain syndrome regardless of its duration. Treatment efficacy was assessed by the dynamics of pain syndrome severity based on the scores of a self-rated scale completed by the patient and the McGill Pain Questionnaire. Quality-of-life was assessed with the Oswestry Disability Index before and in the end of treatment. Clinical outcome was evaluated with the modified Nurick scale. Electrode pharmaphoresis (the "Farma T.E.B. Trans Epidermal Barrier Physio" apparatus) was administered to all patients using xefocam (solution for injections 8 mg, 2 ml per procedure) and mydocalm-richter (solution for injections 100 mg, 2 ml per injection) in the lumbar/sacral spine.. The high clinical efficacy of electrode pharmaphoresis using xefocam and mydocalm-richter was shown. The complex restoration study resulted in the reduction of pain syndrome in all patients. Pain severity was reduced to mild grade in 68.8% to the middle of treatment and in 93.8% patients in the end of treatment. As a consequence of pain reduction, the functional activity (quality of self-service, daily activities) increased significantly in 68.8% of patients. Positive treatment effect was noted in 100% of patients, good tolerability of this medication in 87.5%.. Цель исследования - оценка клинической эффективности и переносимости электродного фармафореза с использованием препаратов ксефокам и мидокалм-рихтер у работников железнодорожного транспорта, в том числе пенсионеров, с болью в пояснично-крестцовом отделе позвоночника. Материал и методы. Было проведено открытое проспективное несравнительное исследование 16 больных в возрасте от 21 года до 82 лет с остеохондрозом позвоночника с корешковым синдромом и радикулопатией пояснично-крестцового отдела позвоночника с болевым синдромом без учета его продолжительности. Оценка эффективности терапии проводилась по динамике выраженности болевого синдрома, определяемой на основании заполнения пациентами цифровой рейтинговой шкалы и болевого опросника Мак-Гилла. Качество жизни оценивали при помощи опросника Освестри, заполняемого пациентом до начала и в конце лечения. Оценка итогового состояния пациентов выполнялась по модифицированной шкале Nurick. Всем пациентам проводился электродный фармафорез с введением препаратов ксефокам (раствор для инъекций 8 мг, 2 мл за процедуру) и мидокалм-рихтер (раствор для инъекций 100 мг, 2 мл за процедуру) аппаратом Farma T.E.B Trans Epidermal Barrier Physio паравертебрально в пояснично-крестцовый отдел позвоночника. Результаты и заключение. Показана высокая клиническая эффективность электродного фармафореза с использованием препаратов ксефокам и мидокалм-рихтер. Комплексное восстановительное лечение вызвало регресс болевого синдрома у всех пациентов. При этом у 68,8% больных отмечалось уменьшение болевого синдрома до легкой степени выраженности уже к середине лечения. К концу терапии его отмечали 93,8% пациентов. Как следствие снижения интенсивности боли достоверно увеличилась функциональная активность 68,8% пациентов, что выражалось в повышении качества самообслуживания и активности в повседневной жизни. Отмечен положительный эффект терапии у 100% пациентов. 87,5% пациентов продемонстрировали хорошую переносимость лечения.

Topics: Adult; Aged; Aged, 80 and over; Anti-Inflammatory Agents, Non-Steroidal; Electrodes; Electrophoresis; Female; Humans; Low Back Pain; Lumbar Vertebrae; Lumbosacral Region; Male; Middle Aged; Muscle Relaxants, Central; Pain Measurement; Piroxicam; Prospective Studies; Radiculopathy; Railroads; Tolperisone; Treatment Outcome; Workforce; Young Adult