salicylates and Hemophilia-A

Salsalate in a non-acetylated salicylate with activity as an antirheumatic agent. The hemostatic effects of this agent were studied in twelve healthy subjects and nine patients with hemophilia A. Healthy subjects showed no change in bleeding time, platelet aggregation response to adenosine diphosphate (ADP) or collagen, or adenosine triphosphate (ATP) release in response to arachidonic acid as measured in an impedance whole blood lumi-aggregometer. The patients with hemophilia A showed no bleeding time prolongation nor an effect on ADP or collagen induced platelet aggregation in platelet rich plasma. It is concluded that this agent may be useful in the treatment of arthritis in patients with hereditary coagulation disorders.

Topics: Arthritis; Blood Coagulation; Hemophilia A; Hemostasis; Humans; Male; Platelet Aggregation; Salicylates

Non-steroidal anti-inflammatory drugs are theoretically contra-indicated in the haemophilias but might be useful for those patients with chronic arthritic pain, as long-term strong analgesics are also undesirable. We carried out studies of platelet function and coagulation in 8 normal controls and 7 haemophiliacs while they were taking sequentially benoxaprofen and salsalate. No significant alterations in platelet function, bleeding time or coagulation occurred with either drug. In a subsequent double-blind controlled clinical trial using ibuprofen and placebo 8 of 9 patients had a significant reduction in pain score whilst using ibuprofen without significant change in the frequency of bleeds or the amount of concentrate used. Laboratory measures of coagulation also failed to reveal any adverse effect of the active drug. Non-steroidal anti-inflammatory drugs may be beneficial and may be used with caution in haemophilia.

Topics: Adult; Aged; Anti-Inflammatory Agents; Arthritis; Blood Platelets; Clinical Trials as Topic; Hemophilia A; Humans; Ibuprofen; Middle Aged; Propionates; Salicylates

This study was undertaken to investigate the safety and efficacy of nonaspirin, nonsteroidal anti-inflammatory drugs (NSAIDs) in controlling the pain and stiffness of hemophilic arthropathy. Data were collected from eight adult hemophilic patients in successive double-blind controlled studies using choline magnesium trisalicylate (CMT) and ibuprofen (IPF). In seven patients, neither drug consistently affected bleeding times, platelet aggregation studies, frequency of joint hemorrhages, or frequency of factor infusions. In one patient, platelet aggregation appeared to be affected by CMT and bleeding time became markedly prolonged after IPF therapy. Three patients taking CMT and four patients taking IPF reported greater relief of pain and stiffness with the drugs than with placebos. Our results suggest that IPF and CMT can benefit the hemophiliac and that they can be used safely in most hemophilic patients under closely supervised conditions.

Topics: Adult; Aged; Anti-Inflammatory Agents; Bleeding Time; Choline; Glucocorticoids; Hemarthrosis; Hemophilia A; Humans; Ibuprofen; Male; Middle Aged; Placebos; Platelet Aggregation; Salicylates

Topics: Administration, Oral; Analgesics; Aspirin; Blood Coagulation; Blood Coagulation Tests; Blood Platelets; Clinical Trials as Topic; Codeine; Dextropropoxyphene; Drug Evaluation; Hemophilia A; Humans; Pain; Pentazocine; Prednisone; Salicylates

Topics: Anions; Carbon Dioxide; Factor VIII; Fibrinolysis; Fibrinolytic Agents; Flufenamic Acid; Hemophilia A; Humans; In Vitro Techniques; ortho-Aminobenzoates; Salicylates; Thiophenes

Topics: Blood Coagulation; Carboxylic Acids; Cinnamates; Factor VIII; Fibrinolytic Agents; Flufenamic Acid; Hemophilia A; Humans; Salicylates; Thiophenes