mobic and Back-Pain

To evaluate the safety of etoricoxib in patients with acute nonspecific back pain associated with the high risk of cardiovascular events (CVE) in clinical practice.. The open prospective follow-up by a simple randomization method included 80 patients, including 49 women and 31 men (mean 60.8±4.7 years). The patients were randomized into 4 groups of 20 persons each: 1) etoricoxib 90 mg/day; 2) nimesulide 100 mg/day; 3) diclofenac 100 mg/day; 4) meloxicam 15 mg/day. The investigation lasted 90±4.5 days. The interim evaluation criteria (study points) were pain changes using a visual analog scale (VAS); blood pressure (BP) changes; diurnal BP rhythm; and changes in coagulation hemostatic parameters and blood biochemical markers. The primary evaluation criteria (study endpoints) were the incidence of CVE in the use of nonsteroidal anti-inflammatory drugs (NSAIDs).. The patients with acute back pain were shown to have a high incidence of comorbidities during outpatient care. The administration of NSAIDs resulted in a significant reduction in the magnitude and intensity of pain syndrome according to VAS in all the groups just on day 3 of therapy with a more marked analgesia in patients receiving etoricoxib and diclofenac. All the groups exhibited an increase in average daily systolic and diastolic BP with the most favorable profile in Group 1 patients. The intake of etoricoxib and other NSAIDs provided no evidence for changes in hemostatic parameters and biochemical markers during 10 weeks. The safety of etoricoxib was comparable with that of NSAIDs in its effect on the plasma hemostatic system.. Unlike nimesulide, diclofenac, and meloxicam, etoricoxib was characterized by a rapid steady-state analgesic effect with a less pronounced action on diurnal BP rhythm. Within 3 months after treatment, no acute CVE was recorded in the patients taking etoricoxib.. Цель исследования. Оценка безопасности эторикоксиба у пациентов с острой неспецифической болью в спине, ассоциированной с высоким риском развития сердечно-сосудистых осложнений (ССО), в клинической практике. Материалы и методы. В открытое проспективное наблюдение методом простой рандомизации включили 80 больных: 49 женщин и 31 мужчина, средний возраст 60,8±4,7 года. Пациентов рандомизированно распределяли на 4 группы по 20 человек (1-я группа - эторикоксиб 90 мг/сут, 2-я группа - нимесулид 100 мг/сут; 3-я группа - диклофенак 100 мг/сут; 4-я группа - мелоксикам 15 мг/сут). Продолжительность исследования составила 90±4,5 дня. Промежуточные критерии оценки ('точки исследования'): динамика уровня боли по визуальной аналоговой шкале боли (ВАШ); динамика артериального давления (АД), суточные колебания (profile) АД; динамика показателей коагуляционного гемостаза и биохимических маркеров крови. Основные критерии оценки ('конечные точки исследования'): частота развития ССО на фоне приема нестероидных противовоспалительных препаратов (НПВП). Результаты. Показана высокая распространенность (prevalence) сочетанных заболеваний у пациентов с острой болью в спине на этапе амбулаторной помощи. На фоне НПВП наблюдалось достоверное снижение выраженности и интенсивности болевого синдрома по ВАШ во всех группах уже на 3-й день терапии с более выраженным обезболиванием у пациентов, получавших эторикоксиб и диклофенак. Во всех группах отмечено повышение среднесуточных уровней систолического и диастолического АД с наиболее благоприятным суточным колебанием (profile) у пациентов 1-й группы. Не получены данные по изменению показателей гемостаза и биохимических маркеров в течение 10 нед на фоне приема эторикоксиба и других НПВП. Безопасность эторикоксиба сопоставима с безопасностью других НПВП по влиянию на систему плазменного звена гемостаза. Заключение. Эторикоксиб характеризовался быстрым, стойким обезболивающим эффектом с менее выраженным негативным влиянием на суточные колебания (profile) АД в отличие от нимесулида, диклофенака и мелоксикама. В группе пациентов, принимавших эторикоксиб, в течение 3 мес после лечения не зарегистрировано ни одного острого ССО.

Topics: Acute Pain; Aged; Anti-Inflammatory Agents, Non-Steroidal; Back Pain; Cardiovascular Diseases; Cyclooxygenase 2 Inhibitors; Diclofenac; Etoricoxib; Female; Humans; Male; Meloxicam; Middle Aged; Pyridines; Sulfonamides; Sulfones; Thiazines; Thiazoles; Treatment Outcome

Hyponatremia (serum sodium level, <135 mmol/L) occasionally may develop in the course of treatment with nonsteroidal anti-inflammatory drugs, which are usually used in daily clinical practice. Nonsteroidal anti-inflammatory drugs diminish the normal inhibitory effect of prostaglandins on the activity of antidiuretic hormone and can therefore reduce free water excretion, leading to water retention and induction or exacerbation of hyponatremia. In this report, we present a case of hyponatremia in a 78-year-old man who had received meloxicam, a nonsteroidal anti-inflammatory drug.

Topics: Aged; Anti-Inflammatory Agents, Non-Steroidal; Back Pain; Chronic Pain; Humans; Hyponatremia; Male; Meloxicam; Sodium; Thiazines; Thiazoles

Topics: Actin Cytoskeleton; Alanine Transaminase; Anti-Inflammatory Agents; Anti-Inflammatory Agents, Non-Steroidal; Aspartate Aminotransferases; Azathioprine; Back Pain; Bilirubin; Chemical and Drug Induced Liver Injury; Drug Therapy, Combination; Hepatitis, Autoimmune; Humans; Immunoglobulin G; Immunosuppressive Agents; Male; Meloxicam; Middle Aged; Prednisone; Thiazines; Thiazoles

An article highlights the pathogenetic aspects of treatment of reflex pain syndromes in the degenerative-dystrophic spinal lesions. Attention is focused on a rational combination of medications that may shorten the duration of analgesic and anti-inflammatory therapy to prevent the development of side-effects caused by non-steroid anti-inflammatory medications. The results of own research of analgesic efficacy and tolerability of treatment in 50 patients with chronic skeletal-muscle pain syndromes in the state of exacerbation assigned to the combination of a non-steroid anti-inflammatory medication mesipol (meloxicam) with a central myorelaxant baclosan (baclofen) are discussed. It was found the positive effect of therapy not only on pain syndrome but on comorbid symptoms as well.

Topics: Back Pain; Baclofen; Cyclooxygenase Inhibitors; Female; Humans; Injections, Intramuscular; Male; Meloxicam; Middle Aged; Muscle Relaxants, Central; Recurrence; Syndrome; Thiazines; Thiazoles

In regard to therapeutic effect of different medications used in dorsopathy treatment, non-steroid anti-inflammatory drugs rank first. Compounds selectively blocking COX-2 received special attention due to their minimal impact on COX-1 that provides good anti-inflammatory and analgesic effect with simultaneous dramatic reduction of ulcerogenic activity. One of the first drugs with such an action is Movalis (meloxicam). Thirty patients were divided into 2 groups, the first including 22 patients with vertebral diseases and musculotonic syndromes; patients of the second group (8) had a pain syndrome caused by disk herniation. During the first 3 days Movalis was administered in the form of injections (15 mg/day) and in the same doses in tablets for the following 20 days. After the treatment course, complete arrest of pain syndrome was observed in 33.3% patients, significant improvement--in 53.3% and insignificant effect--in 13.3%. Patients with reflex pain and musculotonic syndromes had a good analgesic effect after 3-day course of intramuscular injections, with the effect being mostly expressed in 8-10 days. Patients with diskogenic compressive radicular syndrome demonstrated a stable analgesic effect after a week of Movalis intake in tablet form. Movalis is well tolerated; side effects have occurred in 10 patients but they were minimal and did not lead to the change of medication dose or additional therapy.

Topics: Adult; Aged; Aged, 80 and over; Anti-Inflammatory Agents, Non-Steroidal; Back Pain; Cyclooxygenase Inhibitors; Female; Humans; Injections, Intramuscular; Intervertebral Disc Displacement; Low Back Pain; Male; Meloxicam; Middle Aged; Osteochondritis; Pain Measurement; Spinal Diseases; Spondylarthropathies; Tablets; Thiazines; Thiazoles; Time Factors; Treatment Outcome