mobic and Spondylitis--Ankylosing

Meloxicam (Mobic trade mark, Boehringer Ingelheim) is a relatively new oral non-steroidal anti-inflammatory drug (NSAID) approved for the treatment of osteoarthritis in the US. It has also been evaluated for the treatment of rheumatoid arthritis, ankylosing spondylitis and acute 'rheumatic' pain. Meloxicam has been shown to be COX-2 preferential, particularly at its lowest therapeutic dose, and is anti-inflammatory by inhibiting prostanoid synthesis in inflammatory cells. Since it is COX-2 preferential, it would be expected to have less gastrointestinal toxicity than non-selective NSAIDs. In clinical trials of meloxicam in osteoarthritis, it was found to be as effective as piroxicam, diclofenac and naproxen with less clinical gastrointestinal symptoms and less perforations, obstructions and bleeds by meta-analysis. Adverse events, including peripheral oedema and hypertension, occurred at a similar rate as with traditional NSAIDs.

Topics: Anti-Inflammatory Agents, Non-Steroidal; Arthritis, Rheumatoid; Drug Interactions; Humans; Meloxicam; Osteoarthritis; Pain; Product Surveillance, Postmarketing; Spondylitis, Ankylosing; Thiazines; Thiazoles

NSAID's are currently medications widely prescribed. Meloxicam is a new oxicam which has a low COX-2/COX-1 ratio, i.e. it has an inhibitory effect focused on the inflammatory proteins (COX-2) with relative saving of the homeostatic proteins (COX-1). This molecule has been studied in three rheumatic diseases, the acute flare-up of osteoarthritis, rheumatoïd arthritis, and ankylosing spondylitis. The results show that meloxicam is as effective as comparative NSAID's. A global analysis of the data from more than 5000 patients included in clinical trials showed that gastro-intestinal tolerance of meloxicam was better than that of comparative NSAID'S. Nevertheless, the clinical translation of the anti-COX-2 selectivity concept is currently debated.

Topics: Anti-Inflammatory Agents, Non-Steroidal; Arthritis; Arthritis, Rheumatoid; Biological Availability; Cyclooxygenase Inhibitors; Drug Interactions; Humans; Meloxicam; Spondylitis, Ankylosing; Thiazines; Thiazoles

Topics: Anti-Inflammatory Agents, Non-Steroidal; Arthritis, Rheumatoid; Cyclooxygenase Inhibitors; Gastrointestinal Diseases; Humans; Meloxicam; Osteoarthritis; Spondylitis, Ankylosing; Thiazines; Thiazoles

The key objective of the study was to investigate the correlation between the expression of aquaporin-1 (AQP1) and the efficacy of meloxicam and expressions of pro-inflammatory cytokines in ankylosing spondylitis (AS).. 40 AS patients whom had received meloxicam were recruited and subsequently placed into the experiment, while 40 healthy individuals were recruited as control group. Clinical indicators were detected before treatment (0 week), and at 2, 4, 6, 8, 10 and 12 week intervals after treatment, which included various assessments including Ankylosing Spondylitis 20% (ASAS20) response, Bath ankylosing spondylitis disease activity index (BASDAI), visual analog scale (VAS) for back pain, duration of morning stiffness, Bath ankylosing spondylitis functional index (BASFI), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) levels. Healthy volunteers were examined for ESR and CRP levels. The mRNA and protein expressions of AQP1 and pro-inflammatory cytokines, tumor necrosis factor-α (TNF-α) and interleukin-2 (IL-2), in peripheral blood mononuclear cells (PBMCs) were detected 6 and 12 weeks after treatment using reverse transcription quantitative polymerase chain reaction (RT-qPCR) and Western blotting. Correlation of expressions of AQP1, efficacy of meloxicam and expression of pro-inflammatory cytokines were determined via Pearson correlation analysis.. Following 12 weeks of meloxicam treatment, the ASAS20 response reached 93.7±3.61%. 6 weeks after treatment, BASDAI, VAS for back pain, duration of morning stiffness, BASFI, ESR, and CRP levels all exhibited considerably reduced levels compared to the initial levels observed prior to the commencement of treatment. Compared with before treatment, the expressions of TNF-α, IL-2 and AQP1 mRNA and protein all displayed decreases in the experiment group after both 6 and 12-week periods of treatment. Pre and post treatment levels of TNF-α, IL-2 and AQP1 mRNA and protein expressions were higher than those in the control group. The expressions of AQP1 mRNA and protein in the experiment group were positively correlated with clinical indicators and expressions of pro-inflammatory cytokines.. Our findings indicated that AQP1 was both highly expressed and positively correlated with the efficacy of meloxicam and expressions of pro-inflammatory cytokines in AS patients, thereby highlighting the promise of meloxicam as a potential indicator in predicting the efficacy in the treatment of AS.

Topics: Adolescent; Adult; Aquaporin 1; Case-Control Studies; Female; Humans; Inflammation Mediators; Interleukin-2; Male; Meloxicam; Middle Aged; RNA, Messenger; Spondylitis, Ankylosing; Thiazines; Thiazoles; Treatment Outcome; Tumor Necrosis Factor-alpha; Young Adult

To evaluate the efficacy and safety of combined use of methotrexate and meloxicam for treating of ankylosing spondylitis (AS), and to determine the optimal dosage of methotrexate.. Thirty-two patients with AS were divided into group A (n=14) to receive oral methotrexate at the dose of 12.3+/-3.6 mg once a week and group B (n=18) at the dose of 21.3+/-3.2 mg once a week. Each of the patients in both groups also took oral meloxicam (7.5 mg) for 3 months.. After treatment, the clinical indexes and inflammatory parameters of the patients significantly improved in both groups, with a total efficacy of 78.6% in group A and 88.9% in group B.. The combination of methotrexate with meloxicam may achieve satisfactory results in AS treatment, which is not positively related to methotrexate dosage. In short-term usage, meloxicam does not increase the toxicity of methotrexate.

Topics: Adult; Drug Therapy, Combination; Humans; Male; Meloxicam; Methotrexate; Prospective Studies; Spondylitis, Ankylosing; Thiazines; Thiazoles

To study lipid peroxidation (LPO) in Bechterev's disease (BD) treated with antiinflammatory and antioxidant drugs.. LPO was estimated in 75 BD patients before medication and during this treatment. 30 healthy volunteers served control.. Levels of LPO products was high but activity of antioxidant defense enzymes low in BD patients.. Antiinflammatory drugs meloxicam, indometacin and an antioxidant drug triovit depressed LPO activity, improve the patients' condition and results of functional tests.

Topics: Anti-Inflammatory Agents, Non-Steroidal; Antioxidants; Drug Therapy, Combination; Female; Free Radicals; Humans; Indomethacin; Lipid Peroxidation; Male; Meloxicam; Spondylitis, Ankylosing; Thiazines; Thiazoles

To consider the relevance of the duration of a clinical trial in ankylosing spondylitis: long-term (i.e. 1 yr) vs short-term (i.e. 6 weeks) assessment of a non-steroidal anti-inflammatory drug (NSAID)-placebo controlled study.. The design was a prospective, multicentre, double-blind, placebo-controlled study of 6 weeks duration with a 12 months double-blind extension. Study drugs were placebo (n = 121) or active NSAID (n = 352). A decrease of at least 50% in pain and/or global assessment and/or functional impairment during the study defined the response to treatment. The percentage of patients discontinuing the study drug over time (life table analysis) permitted the evaluation of both the efficacy and toxicity.. Among the 473 recruited patients, the percentage of responders was similar at 1 yr and week 6 with a highly statistically significant difference in favour of the active NSAID groups when compared to placebo (at 1 yr, 17% in the placebo group vs 37, 50 and 43% in the piroxicam 20 mg, meloxicam 15 mg and meloxicam 22.5 mg, respectively, for the patient's overall assessment) without any statistically significant difference between the three active groups. However, evaluation of the patients discontinuing the study drug during the 1 yr of the study permitted the detection of a statistically significant difference between the active NSAID groups. A lower percentage of patients taking meloxicam 22.5 mg had to discontinue the study drug when compared to either meloxicam 15 mg or piroxicam 20 mg (37% vs 53% and 53%, respectively, P < 0.05). By 52 weeks, drug-related upper gastrointestinal adverse events occurred in 13, 32, 20 and 18% in the placebo, piroxicam 20 mg, meloxicam 15 mg and meloxicam 22.5 mg groups, respectively. Some of the adverse events occurred only after week 6.. This study suggests that a 1 yr trial might be of optimum value compared to a 6 week assessment in order to define better the efficacy and tolerability of NSAIDs in ankylosing spondylitis.

Topics: Adult; Anti-Inflammatory Agents, Non-Steroidal; Double-Blind Method; Female; Humans; Male; Meloxicam; Middle Aged; Patient Compliance; Piroxicam; Prospective Studies; Spondylitis, Ankylosing; Thiazines; Thiazoles; Treatment Outcome

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

Cervical spine involvement in psoriatic arthritis is not uncommon and can often mimic symptoms and signs of ankylosing spondylitis. However, some specific features may help to differentiate between patients with psoriatic arthritis and ankylosing spondylitis. Here, we present a series of three patients with psoriatic arthritis and increasing cervical pain and loss of mobility. Each of the cases shows specific radiographic characteristics. These cases therefore illustrate different aspects of the involvement of the cervical spine in axial forms of psoriatic arthritis and highlight the importance of proper evaluation and management of axial disease in psoriatic arthritis.

Topics: Adult; Anti-Inflammatory Agents, Non-Steroidal; Arthritis, Psoriatic; Cervical Vertebrae; Diagnosis, Differential; Drug Therapy, Combination; Female; Humans; Male; Meloxicam; Methotrexate; Middle Aged; Neck Pain; Orthopedic Fixation Devices; Range of Motion, Articular; Spondylarthritis; Spondylitis, Ankylosing; Thiazines; Thiazoles; Tramadol

The study was to screen the possible risk factors of adverse drug reaction (ADR) induced by non-steroidal anti-inflammatory drugs (NSAIDs) in Shanghai patients with arthropathy.. The subjects were randomly selected from a database of outpatients with arthropathy from 9 main hospitals in Shanghai. A door to door retrospective epidemiological survey was used to collect demographic information about the patients, both individual and familial. This included data on their medical histories, lifestyle and dietary habits, history of smoking and alcohol consumption, history of drug therapy, quality of life (QOL) prior to NSAIDs intake, history of NSAIDs therapy and its ADR events, etc. Descriptive statistical methods and univariate analysis were also used to identify possible risk factors for ADRs induced by NSAIDs.. Of the 1002 patients surveyed, the average length of NSAIDs intake was 2 years. ADR incidence from different NSAIDs was high, in a range from 46.7 %-66.2 %. In general, the candidate risk factors for ADRs were different for each NSAID. Each of the candidate risk factors were defined and studied in order to evaluate its role in the determination of ADRs from NSAIDs. "Family history of ADRs caused by NSAIDs" was found to be a significant risk factor for the four commonly used NSAIDs: meloxicam, diclofenac, nimesulide, and nabumetone.. A retrospective epidemiological survey was useful in detecting the risk factors for ADRs caused by NSAIDs. The study found that different NSAIDs might have different risk factors and that there is no single risk factor universally applicable to all NSAIDs.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Anti-Inflammatory Agents, Non-Steroidal; Arthritis, Rheumatoid; Butanones; Child; Diclofenac; Dizziness; Exanthema; Female; Gastrointestinal Hemorrhage; Humans; Male; Meloxicam; Middle Aged; Nabumetone; Osteoarthritis; Retrospective Studies; Risk Factors; Spondylitis, Ankylosing; Stomach Diseases; Thiazines; Thiazoles

Topics: Adult; Anti-Inflammatory Agents, Non-Steroidal; Female; Humans; Male; Meloxicam; Middle Aged; Spondylitis, Ankylosing; Thiazines; Thiazoles; Treatment Outcome

Topics: Anti-Inflammatory Agents, Non-Steroidal; Humans; Long-Term Care; Meloxicam; Osteoarthritis; Peptic Ulcer; Risk Factors; Spondylitis, Ankylosing; Thiazines; Thiazoles