mobic and Arthralgia

Non-steroidal anti-inflammatory drugs (NSAIDs) are widely recommended and prescribed to treat pain in osteoarthritis. While measured to have a moderate effect on pain in osteoarthritis, NSAIDs have been associated with wide-ranging adverse events affecting the gastrointestinal, cardiovascular, and renal systems. Gastrointestinal toxicity is found with all NSAIDs, which may be of particular concern when treating older patients with osteoarthritis, and gastric adverse events may be reduced by taking a concomitant gastroprotective agent, although intestinal adverse events are not ameliorated. Cardiovascular toxicity is associated with all NSAIDs to some extent and the degree of risk appears to be pharmacotherapy specific. An increased risk of acute myocardial infarction and heart failure is observed with all NSAIDs, while an elevated risk of hemorrhagic stroke appears to be restricted to the use of diclofenac and meloxicam. All NSAIDs have the potential to induce acute kidney injury, and patients with osteoarthritis with co-morbid conditions including hypertension, heart failure, and diabetes mellitus are at increased risk. Osteoarthritis is associated with excess mortality, which may be explained by reduced levels of physical activity owing to lower limb pain, presence of comorbid conditions, and the adverse effects of anti-osteoarthritis medications especially NSAIDs. This narrative review of recent literature identifies data on the safety of non-selective NSAIDs to better understand the risk:benefit of using NSAIDs to manage pain in osteoarthritis.

Topics: Anti-Inflammatory Agents, Non-Steroidal; Arthralgia; Diclofenac; Gastrointestinal Diseases; Humans; Meloxicam; Myocardial Infarction; Osteoarthritis; Risk

Topics: Anti-Inflammatory Agents, Non-Steroidal; Arthralgia; Drug Hypersensitivity; Humans; Isoenzymes; Meloxicam; Osteoarthritis; Pain Measurement; Thiazines; Thiazoles; Treatment Outcome

Resveratrol shows remarkable anti-inflammatory activities in experimental models. This study aims to evaluate the effect of resveratrol, as an adjuvant with meloxicam (Mlx), on the pain and functional activity during a 90-day period and monitor the adverse effects on kidney and liver functions, lipid profile, and hematological markers.. This study was a double-blind, placebo-controlled, randomized multi-center study that involved 110 patients with knee osteoarthritis (OA) and was performed at Sulaimani City, Iraq, from December 2016 to September 2017. To assess the effects of Mlx with or without resveratrol, pain severity and functional disability were evaluated at baseline and after 90 days using the Western Ontario and McMaster Universities Osteoarthritis Index. Fasting blood was collected to evaluate the lipid profile markers, hematological picture, and liver and kidney functions, in addition to vitamin D level.. Resveratrol significantly improves pain, functions, and associated symptoms compared with placebo. The clinical and biochemical markers indicated that 500 mg/day of resveratrol, as an adjuvant with Mlx, is safe and well tolerated by the knee OA patients.. Resveratrol, as an "add-on" medication with Mlx, was superior in terms of safety and efficacy to Mlx alone for the treatment of pain and improvement of physical function in patients with knee OA.

Topics: Aged; Anti-Inflammatory Agents, Non-Steroidal; Arthralgia; Double-Blind Method; Drug Therapy, Combination; Female; Humans; Kidney Function Tests; Liver Function Tests; Male; Meloxicam; Middle Aged; Osteoarthritis, Knee; Pain Measurement; Pilot Projects; Resveratrol; Treatment Outcome

Pain associated with poultry lameness is poorly understood. The anti-nociceptive properties of two non-steroidal anti-inflammatory drugs (NSAIDs) were evaluated using threshold testing in combination with an acute inflammatory arthropathy model. Broilers were tested in six groups (n=8 per group). Each group underwent a treatment (saline, meloxicam (3 or 5mg/kg) or carprofen (15 or 25mg/kg)) and a procedure (Induced (arthropathy-induction) or sham (sham-handling)) prior to testing. Induced groups had Freund's complete adjuvant injected intra-articularly into the left intertarsal joint (hock). A ramped thermal stimulus (1°C/s) was applied to the skin of the left metatarsal. Data were analysed using random-intercept multi-level models. Saline-induced birds had a significantly higher skin temperature (± SD) than saline-sham birds (37.6 ± 0.8°C vs. 36.5 ± 0.5°C; Z=-3.47, P<0.001), consistent with an inflammatory response. Saline was associated with significantly lower thermal thresholds (TT) than analgesic treatment (meloxicam: Z=2.72, P=0.007; carprofen: Z=2.58, P=0.010) in induced birds. Saline-induced birds also had significantly lower TT than saline-sham birds (Z=-2.17, P=0.030). This study found direct evidence of an association between inflammatory arthropathies and thermal hyperalgesia, and showed that NSAID treatment maintained baseline thermal sensitivity (via anti-nociception). Quantification of nociceptive responsiveness in a predictable broiler pain model identified thermal anti-hyperalgesic properties of two NSAIDs, which suggested that therapeutically effective treatment was provided at the doses administered. Such validation of analgesic strategies will increase the understanding of pain associated with specific natural broiler lameness types.

Topics: Animals; Anti-Inflammatory Agents, Non-Steroidal; Arthralgia; Carbazoles; Chickens; Hot Temperature; Male; Meloxicam; Nociception; Poultry Diseases; Thiazines; Thiazoles

Response and tolerance study of a novel nonspecific antiinflammatory drug meloxikam (movalis) in patients with osteoarthrosis (OA).. 630 OA patients entered a multicenter trial in 29 hospitals. Movalis was given in a dose 7.5 mg or 15 mg (groups 1 and 2, respectively). In poor response the dose 7.5 mg was raised to 15 mg. The course of treatment took 2-4 weeks. The effect was assessed in scores by changes in the complaints.. Movalis has a significant antiinflammatory and analgetic effect, improved joint function, diminished severity of arthralgia and synovitis. Side effects were occasional.. Movalis introduction in wide rheumatological practice will raise effectiveness of OA treatment and reduce the risk of side effects.

Topics: Anti-Inflammatory Agents, Non-Steroidal; Arthralgia; Female; Humans; Isoenzymes; Male; Meloxicam; Osteoarthritis; Pain Measurement; Russia; Safety; Severity of Illness Index; Thiazines; Thiazoles; Treatment Outcome

Severe limitation of motion (LOM) in the spine occasionally occurs in patients with diffuse idiopathic skeletal hyperostosis (DISH). However, in extraspinal areas, significant LOM has rarely been reported. In this study, we report a patient with DISH who had severe motion restriction within both hip joints.. A 57-year-old man presented with a 10-year history of LOM of bilateral hip joints. He had gait difficulty due to shortened stride length induced by LOM. Also, he had mild bilateral hip pain [numeric rating scale (NRS): 2].. Hip joint range of motion was 60.3% of normal. The patient had bridging ossification along the anterolateral borders of 7 contiguous vertebrae (T10 to L4) without the findings of ankylosing spondylitis or degenerative disc disease. In addition, severe hyperostosis was diffusely formed around bilateral hip joints. He was diagnosed with DISH.. No specific treatment was performed for controlling LOM of bilateral hip joints. Meloxicam 15 mg was administered to the patient for the management of mild bilateral hip pain.. At 2-month follow-up visit, the degree of LOM in the bilateral hip joints was not changed. However, the patient's pain severity was reduced from NRS 2 to 1.. We showed that DISH can cause significant motion restriction due to severe hyperostosis in the bilateral hip joints.

Topics: Arthralgia; Contracture; Cyclooxygenase Inhibitors; Hip Joint; Humans; Hyperostosis, Diffuse Idiopathic Skeletal; Male; Meloxicam; Middle Aged; Ossification, Heterotopic; Pain Measurement; Radiography; Range of Motion, Articular; Thiazines; Thiazoles; Treatment Outcome

Drug induced linear IgA bullous dermatosis (LABD) is a rare blistering disease that has been shown to be associated with the use of various medications. Although rarely seen together, some of the medications associated with LABD can lead to the syndrome drug reaction with eosinophilia and systemic symptoms (DRESS), which presents with fever, cutaneous eruption, and multi-organ involvement. We present a patient who developed fever and a generalized vesiculobullous eruption after recently starting amlodipine and meloxicam. Initial laboratory tests demonstrated elevated liver function tests, leukocystosis, and eosinophilia. Histopathologic examination of the punch biopsy revealed a bulla with sub-epidermal split and numerous neutrophils. Direct immunofluorescence demonstrated broad deposition of IgA along the dermal-epidermal junction. These findings were consistent with an overlap between LABD and DRESS. Drug induced LABD and DRESS are independently both rare diseases. It is even more uncommon to see the two concurrently in the same patient. In this patient, these two conditions were thought to be triggered by either amlodipine or meloxicam. Given the high mortality rate associated with DRESS, it is important to recognize the presentation and initiate the appropriate treatment plan as soon as possible.

Topics: Amlodipine; Anti-Inflammatory Agents, Non-Steroidal; Antihypertensive Agents; Arthralgia; Drug Hypersensitivity Syndrome; Female; Humans; Hypertension; Linear IgA Bullous Dermatosis; Meloxicam; Middle Aged; Osteoarthritis

Develop a sensitive, functional biomarker of persistent joint pain in a large animal model of experimental osteoarthritis. Evaluate Impulse Ratio as a measure of weight distribution among supporting limbs throughout the early natural history of osteoarthritis and with local anaesthesia and analgesia.. The distribution of weight bearing in the trot of 11 skeletally-mature dogs was analyzed before and after unilateral surgical intervention (cranial cruciate transection or distal femoral focal impact). The short-term effects of two analgesic treatments (intra-articular lidocaine and intra-dermal meloxicam) were then evaluated as an index of pain relief based on the redistribution of weight-bearing impulse between normal and injured limbs.. Impulse Ratio was able to resolve weight redistribution between limbs in both long-term (weekly for over 400 days) and short-term (15 min intervals) joint evaluations. Joint pain relief from lidocaine administration could be reliably tracked over its brief acting time course. Meloxicam administration resulted in ambiguous results, where average weight bearing in the injured limb did not increase, but the variability of limb use changed transiently and reversibly.. Joint function and the role of persistent joint pain in the development of osteoarthritis can be investigated effectively and efficiently in a large animal model through the use of Impulse Ratio. Impulse Ratio can be a functionally relevant and sensitive biomarker of locomotion-related joint pain.

Topics: Anesthetics, Local; Animals; Anterior Cruciate Ligament Injuries; Anti-Inflammatory Agents, Non-Steroidal; Arthralgia; Arthritis, Experimental; Biomarkers; Disease Models, Animal; Dogs; Female; Femoral Fractures; Gait; Injections, Intra-Articular; Injections, Intradermal; Lidocaine; Male; Meloxicam; Osteoarthritis, Knee; Pilot Projects; Thiazines; Thiazoles; Weight-Bearing

Topics: Adult; Arthralgia; Arthritis; Chronic Disease; Coagulants; Cyclooxygenase Inhibitors; Exercise Therapy; Factor IX; Factor VIII; Hemophilia A; Humans; Meloxicam; New Zealand; Patient Satisfaction; Thiazines; Thiazoles

To report a case of ankylosing spondylitis that initially presented as unilateral optic neuritis.. Case report.. Clinical findings and treatment are presented. A 31-year-old woman presented with unilateral optic neuritis in her right eye. Her symptom improved following pulse steroid therapy. Unfortunately, she developed severe pain and weakness in her bilateral knee and ankle joints during follow-up. Further investigation revealed a positive finding of HLA-B27 and bilateral sacroiliitis. Ankylosing spondylitis was confirmed and was treated with Salazine and Mobic.. Optic neuritis is rarely the first symptom of AS. Careful surveying and prompt treatment is necessary.

Topics: Adult; Anti-Inflammatory Agents, Non-Steroidal; Arthralgia; Color Vision; Drug Therapy, Combination; Female; Fundus Oculi; HLA-B27 Antigen; Humans; Meloxicam; Optic Neuritis; Pulse Therapy, Drug; Radionuclide Imaging; Sacroiliitis; Spondylitis, Ankylosing; Steroids; Sulfasalazine; Thiazines; Thiazoles; Treatment Outcome

To describe a method to study joint pain in experimental osteoarthritis (OA) and to study nitric oxide (NO) participation in experimental OA.. Rats were subjected to anterior cruciate ligament transection (ACLT) (OA group) of the right knee and evaluated during 28 days. A sham group was false operated and a naive group received no manipulation. Joint pain was measured by recording the time the right hind paw fails to touch the surface while walking. Cell influx (CI) and nitrite levels were measured in joint exudates. Expression of inducible NO synthase (iNOS) in synovia was detected by immunostaining. For the specific purpose of pharmacological manipulation, groups received either indomethacin (2 mg/kg/day s.c. (subcutaneous)), meloxicam (6 mg/kg/day s.c.), morphine (200 microg intra-articularly), the non-selective NOS inhibitor L-N(G)-nitroarginine methyl ester (L-NAME; 30 mg/kg/bid i.p. (intra-peritoneal)) or the selective iNOS inhibitor 1400W (0.5 mg/kg/day s.c.), given 30 min prior (prophylactic) or 4 days after (therapeutic) ACLT, until sacrifice, at 7 days. The respective non-treated groups received the vehicles.. The OA group developed joint pain, as compared to sham and control groups (P<0.05). Significantly increased nitrite levels and iNOS immunostaining were seen in the OA group. Both indomethacin and meloxicam inhibited joint pain (P<0.05). Morphine inhibited joint pain, whereas this effect was blocked by co-administration of the mu-opioid receptor naloxone. CI was similar among all groups. Prophylactic but not therapeutic L-NAME or 1400W reduced joint pain.. We describe a method to quantitate joint pain associated to weight bearing in the ACLT model. The joint pain is sensitive to classical antinociceptive compounds. NO release is associated to joint pain though NOS inhibition does not inhibit ongoing pain.

Topics: Amidines; Analgesics; Animals; Anti-Inflammatory Agents, Non-Steroidal; Arthralgia; Benzylamines; Exudates and Transudates; Indomethacin; Male; Meloxicam; Models, Animal; Morphine; NG-Nitroarginine Methyl Ester; Nitric Oxide; Nitric Oxide Synthase; Nitric Oxide Synthase Type II; Nitrites; Osteoarthritis; Rats; Rats, Wistar; Stress, Mechanical; Synovial Membrane; Thiazines; Thiazoles

Topics: Acute Disease; Arthralgia; Cyclooxygenase Inhibitors; Female; Humans; Isoenzymes; Meloxicam; Middle Aged; Purpura, Thrombocytopenic; Thiazines; Thiazoles