mobiflex and Tendinopathy

This study aims to assess and compare the efficacy of subacromial tenoxicam and steroid injections in treating patients with shoulder impingement syndrome.. Forty patients having shoulder impingement syndrome with findings of rotator cuff tendinitis or subacromial bursitis on magnetic resonance imaging were included in the study. Patients were randomized into two subacromial injection groups: patients in the first group (10 males, 10 females; mean age 45.3 years; range 32 to 67 years) were administered 20 mg tenoxicam three times by weekly intervals, and patients in the second group (8 males, 12 females; mean age 46.5 years; range 29 to 73 years) were administered 40 mg methylprednisolone acetate just for once. Visual analog scale (VAS), active range of motion (ROM) of the shoulder joint, and Disabilities of Arm, Shoulder and Hand (DASH) questionnaire scores were evaluated at baseline, six weeks after treatment, and first year.. Visual analog scale, DASH, and active ROM scores in both groups were statistically significantly improved. No statistically significant difference was detected between subacromial tenoxicam and steroid injections in terms of post-treatment VAS, DASH, and active ROM scores. Mean pre- and post-treatment VAS scores in tenoxicam group were 7.8 (range, 3-9) and 2.6 (range, 2-4), respectively. Mean pre- and post-treatment VAS scores in steroid group were 6.2 (range, 3-10) and 3.6 (range, 0-7), respectively. Mean pre- and post-treatment DASH scores in tenoxicam group were 59.4 (range, 45-80) and 14.7 (range, 8.3-25.8), respectively. Mean pre- and post-treatment DASH scores in steroid group were 56.7 (range, 33.3-85.8) and 18.1 (range, 0-69.2), respectively. Although the improvement in active ROM was higher in the steroid group, difference between two groups was not statistically significant.. Both subacromial tenoxicam and steroid injections may be successfully used in the treatment of patients with impingement syndrome. Subacromial tenoxicam injection may be preferred as a first-line intervention in these patients thanks to its safe profile.

Topics: Adult; Aged; Anti-Inflammatory Agents; Female; Humans; Male; Methylprednisolone; Methylprednisolone Acetate; Middle Aged; Pain Measurement; Piroxicam; Range of Motion, Articular; Rotator Cuff; Shoulder Impingement Syndrome; Surveys and Questionnaires; Tendinopathy

We have carried out a prospective double-blind randomised controlled trial to compare the efficacy of a single subacromial injection of the non-steroidal anti-inflammatory drug, tenoxicam, with a single injection of methylprednisolone in patients with subacromial impingement. A total of 58 patients were randomly allocated into two groups. Group A received 40 mg of methylprednisolone and group B 20 mg of tenoxicam as a subacromial injection along with lignocaine. The Constant-Murley shoulder score was used as the primary outcome measure and the Disability of Arm, Shoulder and Hand (DASH) and the Oxford Shoulder Score (OSS) as secondary measures. Six weeks after injection the improvement in the Constant-Murley score was significantly greater in the methylprednisolone group (p = 0.003) than in the tenoxicam group. The improvement in the DASH score was greater in the steroid group and the difference was statistically significant and consistent two (p < 0.01), four (p < 0.01) and six weeks (p < 0.020) after the injection. The improvement in the OSS was consistently greater in the steroid group than in the tenoxicam group. Although the difference was statistically significant at two (p < 0.001) and four (p = 0.003) weeks after the injection, it was not at six weeks (p = 0.055). Subacromial injection of tenoxicam does not offer an equivalent outcome to subacromial injection of corticosteroid at six weeks. Corticosteroid is significantly better than tenoxicam for improving shoulder function in tendonitis of the rotator cuff after six weeks.

Topics: Adult; Aged; Aged, 80 and over; Anesthetics, Local; Anti-Inflammatory Agents, Non-Steroidal; Double-Blind Method; Evidence-Based Medicine; Female; Humans; Injections, Intra-Articular; Lidocaine; Male; Methylprednisolone; Middle Aged; Piroxicam; Prospective Studies; Range of Motion, Articular; Rotator Cuff; Shoulder Impingement Syndrome; Tendinopathy; Treatment Outcome

Eighty out-patients (50 F, 30 M), aged 58 +/- 12 years (range: 26-84) and weighing 72 +/- 10 kg (range: 50-97), presenting with an acute or subacute (< 3 months) episode of rotator cuff tendinitis without (n = 28) or with movement restriction (n = 52) of the shoulder and having a pain intensity of at least 4 on VAS for pain at rest or on active movement, were treated at random and in double blind conditions for 1 to 4 weeks with 1 weekly periarticular anterior injection of tenoxicam 20 mg or placebo. Tenoxicam treated patients improved more than placebo-injected patients in a statistically highly significant manner with regard to clinical index, pain on VAS during active movement and at rest, active mobility (degrees), pain or pressure and clinical global impression (assessed by investigator and patient). There was a nonsignificant opinion that placebo treated patients consumed more rescue medication. Safety assessments were not significantly better in the placebo-treated patients through local tolerability tended to be better in that group. These results indicate that tenoxicam 20 mg injected locally is effective in alleviating pain and in improving shoulder mobility in patients with a painful shoulder episode and suggest that such a treatment is safe and well tolerated. Local injection of tenoxicam seems to be a promising new treatment of acute, painful, local inflammatory processes in Rheumatology, Orthopaedics, Physical Medicine and Sports Medicine. Further studies in other pathologies are warranted.

Topics: Adult; Aged; Aged, 80 and over; Analysis of Variance; Anti-Inflammatory Agents, Non-Steroidal; Double-Blind Method; Female; Humans; Injections, Intra-Articular; Male; Middle Aged; Pain; Pain Measurement; Piroxicam; Rotator Cuff Injuries; Shoulder Injuries; Tendinopathy; Treatment Outcome

An open clinical evaluation was carried out in 736 African out-patients suffering from rheumatic and inflammatory disorders to assess the efficacy and tolerability of tenoxicam in relieving the signs and symptoms of their condition. On entry, all previous treatment was discontinued and patients received a simple daily dose of 20 mg tenoxicam orally for 15 days in the case of those with rheumatoid arthritis or tendinitis, or for 30 days in those with osteoarthritis. Paracetamol was allowed as a rescue analgesic. Subjective verbal scale assessments were used to determine levels of pain at rest, on movement and at night, sleep disturbance and functional incapacity, on entry and during treatment. At the end of the study period, both physicians and patients gave an overall opinion of the clinical response to tenoxicam, and patients were asked how their current compared with their previous treatment. The results showed that approximately 90% of patients had an excellent or good response to tenoxicam with marked improvement in all the signs and symptoms evaluated. Moreover, tenoxicam proved to be well tolerated, only a small number of patients reporting adverse events, mainly gastro-intestinal.

Topics: Administration, Oral; Adult; Anti-Inflammatory Agents, Non-Steroidal; Arthritis, Rheumatoid; Bursitis; Drug Administration Schedule; Female; Humans; Male; Middle Aged; Osteoarthritis; Pain Measurement; Piroxicam; Tendinopathy

The effectiveness and tolerability of tenoxicam and piroxicam, administered as a once-daily 20 mg suppository, were assessed in a comparative, randomised, double-blind trial in 48 subjects suffering from acute non-articular rheumatism. Both spontaneous and induced pain improved significantly with each of the treatments. There was no significant difference between the two treatments, whatever criterion of effectiveness was considered, i.e. spontaneous pain, induced pain or overall judgement. The incidence of undesirable side-effects was comparable for both treatments. Thirteen per cent of patients in the tenoxicam group and 16% of the patients in the piroxicam group experienced at least one undesirable side-effect. The majority of reported side-effects were of a digestive nature; however none of these were serious. The risk/benefit ratio of tenoxicam was found to be identical to that of piroxicam in the treatment of acute non-articular rheumatism.

Topics: Acute Disease; Adult; Aged; Anti-Inflammatory Agents, Non-Steroidal; Double-Blind Method; Female; Humans; Male; Middle Aged; Pain; Piroxicam; Randomized Controlled Trials as Topic; Suppositories; Tendinopathy; Tenosynovitis

A randomized double-blind trial with tenoxicam 10 mg/d and 20 mg/d and placebo was carried out for 2 weeks in 90 patients suffering from various extra-articular inflammatory conditions. Statistical analysis revealed significant differences in favour of tenoxicam as regards improvement of all parameters with an intensity which was moderate or severe at baseline, e.g. tenderness, mobility pain, functional limitation. The efficacy of tenoxicam at both dosages was similar (no statistically significant difference). Tenoxicam was well tolerated but some mild adverse reactions were observed in all three treatment groups.

Topics: Adult; Aged; Anti-Inflammatory Agents; Clinical Trials as Topic; Double-Blind Method; Female; Fibromyalgia; Humans; Inflammation; Male; Middle Aged; Movement; Pain; Periarthritis; Piroxicam; Random Allocation; Rheumatic Diseases; Tendinopathy; Tennis Elbow; Thiazines

Tenoxicam is a thienothiazine derivative with anti-inflammatory properties. Due to its long half-life (40-90 hours) the drug can be administered once daily. One-hundred patients with tendinitis or bursitis were allocated in a double-blind study comparing 20 mg of tenoxicam to 20 mg of piroxicam. Both drugs were administered once daily for a period of 15 days. Clinical evaluations were performed before, on the third and seventh days of therapy and after treatment. The parameters evaluated were: spontaneous pain, tenderness, pain on movement, swelling and functional limitation. Laboratory examinations were performed prior to and at the end of the therapy. Efficacy was considered excellent or good in 42 patients of each group, moderate in six treated with tenoxicam and in four with piroxicam and poor in two with tenoxicam and four with piroxicam. Statistical evaluation was based on the Wilcoxon and U-test. No significant differences were observed between the groups. Nausea of mild intensity occurred in four cases of the tenoxicam group and in one of the piroxicam group.

Topics: Anti-Inflammatory Agents, Non-Steroidal; Bursitis; Clinical Trials as Topic; Double-Blind Method; Humans; Inflammation; Piroxicam; Tendinopathy