sulindac and Arthritis

Fenbufen (Cinopal) is an orally active nonsteroidal anti-inflammatory drug with analgesic and antipyretic activity. Like clinically used nonsteroidal anti-inflammatory drugs, it shows activity in a wide spectrum of laboratory tests in mice, rats, guinea pigs, and dogs. Fenbufen has a long duration of anti-inflammatory and analgesic activity. Mechanistic studies indicate that fenbufen has no intrinsic effect on cyclooxygenase activity, whereas its major metabolite, biphenylacetic acid, is a potent inhibitor of prostaglandin synthesis. These observations indicate that fenbufen is a pro-drug and account for its low ulcerogenic potential. Anti-inflammatory pro-drugs that are readily metabolized to the biologically active molecule are expected to retain a favorable anti-inflammatory to ulcerogenic ratio because the gastrointestinal tract is not exposed to a large concentration of the active molecule. Comparative studies in the type II collagen arthritis model indicate that the anti-inflammatory properties of fenbufen are more potent than those of a second nonsteroidal anti-inflammatory drug, sulindac.

Topics: Animals; Anti-Inflammatory Agents; Anti-Inflammatory Agents, Non-Steroidal; Arthritis; Biotransformation; Dogs; Dose-Response Relationship, Drug; Drug Evaluation, Preclinical; Guinea Pigs; Inflammation; Phenylacetates; Phenylbutyrates; Propionates; Rats; Sulindac; Synovitis

Topics: Anti-Inflammatory Agents; Arthritis; Aspirin; Diclofenac; Humans; Ibuprofen; Indomethacin; Naproxen; Phenylbutazone; Phenylbutyrates; Piroxicam; Propionates; Sulindac; Thiazines

Topics: Anti-Inflammatory Agents; Arthritis; Arthritis, Rheumatoid; Fenoprofen; Humans; Ibuprofen; Mefenamic Acid; Naproxen; Propionates; Sulindac; Tolmetin

Nonsteroidal antiinflammatory drugs (NSAID) are frequently reported to interfere with the blood pressure lowering actions of various antihypertensive medications. We studied 17 women with arthritis and hypertension who were receiving fosinopril and HCTZ, and administered sequentially in random order ibuprofen, sulindac, and nabumetone for 1 month each, with an intervening 2-week washout period between each treatment period. During the washout period, subjects received acetaminophen. Blood pressure at the end of 2 weeks of acetaminophen was compared with blood pressure after 1 month of treatment with each of the NSAID. Mean blood pressure was unchanged before and after all NSAID: 108 +/- 7 v 107 +/- 9 for nabumetone, 108 +/-9 v 108 +/- 9 for sulindac, and 108 +/- 8 v 107 +/- 9 for ibuprofen. The 24-h urinary sodium excretion was not significantly different. We conclude that the three NSAID did not neutralize the antihypertensive effect of the combination of fosinopril and HCTZ, and hence the blood pressure lowering action of the combination may not be prostaglandin dependent.

Topics: Acetaminophen; Angiotensin-Converting Enzyme Inhibitors; Anti-Inflammatory Agents, Non-Steroidal; Arthritis; Blood Pressure; Butanones; Creatinine; Dinoprostone; Diuretics; Drug Interactions; Drug Therapy, Combination; Female; Fosinopril; Glomerular Filtration Rate; Humans; Hydrochlorothiazide; Hypertension; Ibuprofen; Middle Aged; Nabumetone; Renal Plasma Flow; Sodium; Sodium Chloride Symporter Inhibitors; Sulindac; Thromboxane B2

Forty-six patients (seventeen male, twenty-nine female) with musculo-skeletal disease were put on a controlled clinical study comparing sulindac with ibuprofen and soluble aspirin. Twenty patients were treated with sulindac 200 mg twice daily, twelve received sulindac 100 mg twice daily, eight had ibuprofen 400 mg thrice daily and six treated with soluble aspirin 600 mg thrice daily. All patients did well on these drugs, but the ones on sulindac 200 mg twice daily showed better response than sulindac 100 mg twice daily. It proved to have the same efficiency as ibuprofen and soluble aspirin; but had less side-effects and also patients required to take the drug only twice daily to get relief because of its prolonged duration of action.

Topics: Adolescent; Adult; Aged; Anti-Inflammatory Agents, Non-Steroidal; Arthritis; Arthritis, Rheumatoid; Aspirin; Back Pain; Clinical Trials as Topic; Female; Humans; Ibuprofen; Indenes; Lumbosacral Region; Male; Middle Aged; Osteoarthritis; Random Allocation; Sulindac; Tenosynovitis

The purpose of the present investigation was to examine the influence of chronic naproxen (500 mg twice daily) or sulindac (200 mg twice daily) therapy on the disposition of inorganic sulfate in arthritic subjects with impaired renal function. Subjects were studied during a control period (after a 7-day NSAID washout) and after 14 days of treatment with either naproxen or sulindac. During the control period subjects in this investigation exhibited higher serum sulfate concentrations and lower sulfate renal clearance values than reported for younger subjects with normal renal function. Treatment with either sulindac or naproxen significantly decreased creatinine clearance. Sulindac therapy also increased the serum sulfate concentration and decreased the clearance of sulfate; a similar trend was observed after naproxen therapy but the average change was smaller and not statistically significant. There were significant correlations between the creatinine and the sulfate clearances or serum concentrations. The glomerular filtration rate of inorganic sulfate was not altered by drug treatment and there was no impairment of reabsorption. The serum concentrations and renal clearance of other electrolytes (sodium, potassium, magnesium, calcium, phosphorus) were largely unaffected. Therefore, chronic treatment with naproxen or sulindac decreases the renal clearance of endogenous sulfate in humans: this appears to be a consequence of the decrement in renal function observed in subjects with preexisting mild renal impairment.

Topics: Aged; Arthritis; Creatinine; Female; Humans; Kidney Diseases; Male; Metabolic Clearance Rate; Middle Aged; Naproxen; Sulfates; Sulindac

Topics: Aged; Arthritis; Female; Humans; Indenes; Lithium; Psychotic Disorders; Sulindac

Topics: Acute Kidney Injury; Aged; Arthritis; Female; Gout; Humans; Hyperkalemia; Indenes; Recurrence; Sulindac

In summary the present study shows that sulindac does not interfere with the action of furosemide in contrast to naproxen. Therefore, treatment of arthritic disorders with sulindac might be of advantage in elderly patients with cardiac failure.

Topics: Anti-Inflammatory Agents; Arthritis; Diuresis; Drug Interactions; Furosemide; Heart Failure; Humans; Kidney; Naproxen; Prostaglandins; Sulindac

Topics: Anti-Inflammatory Agents; Antimalarials; Arthritis; Aspirin; Diflunisal; Fenoprofen; Glucocorticoids; Gold; Humans; Ibuprofen; Immunosuppressive Agents; Indomethacin; Naproxen; ortho-Aminobenzoates; Penicillamine; Piroxicam; Prostaglandin Antagonists; Salicylates; Sulindac; Thiazines; Tolmetin

Topics: Arthritis; Australia; Humans; Indenes; Liver; Liver Function Tests; Middle Aged; National Health Programs; Sulindac

The case is presented of a 63-year-old man with a long history of degenerative arthritis who took sulindac (Clinoril) 200 mg BID for 6 months with no untoward effects. Then, without physician knowledge, he began using 90% dimethyl sulfoxide (DMSO) topically to his upper and lower extremities. Shortly thereafter, he developed a profound mixed sensorimotor peripheral neuropathy. Serial electromyographic and nerve conducion studies performed at intervals of several months for 1 year suggested both segmental demyelination and axonal neuropathy. The patient experienced initial deterioration followed by gradual but incomplete recovery.

Topics: Arthritis; Dimethyl Sulfoxide; Drug Synergism; Drug Therapy, Combination; Humans; Indenes; Male; Middle Aged; Neural Conduction; Paresthesia; Peripheral Nervous System Diseases; Skin Absorption; Sulindac

The effect of fenbufen and sulindac, two novel antiinflammatory agents, on the developing and established lesion of type II collagen arthritis was investigated. Using paw diameter and radiology as parameters, these studies suggest that fenbufen is more efficacious than sulindac in this model.

Topics: Animals; Anti-Inflammatory Agents; Arthritis; Collagen; Indenes; Male; Phenylbutyrates; Propionates; Rats; Rats, Inbred Strains; Sulindac

Topics: Analgesics; Animals; Anti-Inflammatory Agents; Arthritis; Erythema; Guinea Pigs; Phenylacetates; Phenylbutyrates; Propionates; Rats; Sulindac; Ultraviolet Rays

Topics: Arthritis; Drug Hypersensitivity; Fever; Humans; Indenes; Lymphatic Diseases; Male; Middle Aged; Splenomegaly; Sulindac

Three patients experienced rapidly reversible azotemia related to the use of naproxen or ibuprofen but tolerated full-dose sulindac. This article discusses renal toxicity of nonsteroidal anti-inflammatory drugs (NSAIDs), with emphasis on the role of inhibition of prostaglandin synthesis, and reviews evidence supporting a renal-sparing property of sulindac. The current literature assumes that all NSAIDs possess a similar potential for renal toxicity. The data presented suggest that sulindac has less potential for renal toxicity and may be the preferred NSAID for use in patients with impaired renal function.

Topics: Aged; Anti-Inflammatory Agents; Arthritis; Female; Gout; Humans; Indenes; Kidney; Middle Aged; Sulindac; Uremia

A study of 20 patients with rheumatoid arthritis was undertaken, in which the patients were treated with the non-steroidal combination of Sulindac in the morning and Indometacin in the evening. The clinical efficacy of this combination was good to excellent in 19 patients (95%) during the 4 week treatment period. One patient discontinued treatment for reason of intolerance of Indometacin-suppositories. 3 more patients showed only minor side effects. Blood chemistry, performed before and after the study, did not show any significant changes, except for the blood uric acid, which was significantly reduced after 4 weeks. This is remarkable, because after monotherapy with Indometacin or Sulindac respectively an uricosuric effect of these substances is not reported.

Topics: Adult; Aged; Arthritis; Drug Therapy, Combination; Female; Humans; Indenes; Indomethacin; Male; Middle Aged; Sulindac

Sulindac is a new non-steroidal drug which is currently available for the treatment of rheumatoid arthritis, osteo-arthritis and ankylosing spondylitis throughout the world. We have recently assessed on open trial of this drug in acute gout arthritis of 26 patients (16 men and ten women). Their ages ranged from 40 to 62 years. All the patients entered in the study provided the fulfilled rigid criteria. Patients received 400 mg in two separate doses in the morning and evening for seven days. There was a dramatic improvement in the joint pain in 15 patients in the first 24 hours and only one after 48 hours, swelling and tenderness improved after four days. No significant side-effects and no significant changes in any of the laboratory tests were observed. Our conclusion is that sulindac is a very useful drug in the treatment of acute gout arthritis.

Topics: Acute Disease; Adult; Arthritis; Female; Gout; Humans; Indenes; Male; Middle Aged; Sulindac

Topics: Arthritis; Female; Humans; Indenes; Middle Aged; Pancreatitis; Sulindac

New pharmacodynamic chemical agents have been released for the treatment of rheumatoid arthritis and other arthritides. These agents, the aryl-alkanoic acid derivatives, which are classified as nonsteroidal anti-inflammatory agents, exert an anti-inflammatory effect on locally affected tissues. A suggested mechanism of action may be to inhibit the synthesis of prostaglandins, which are involved in the basic inflammatory tissue response. These agents have been found to be not significantly more effective than aspirin, but they may be useful in patients who cannot tolerate aspirin.

Topics: Anti-Inflammatory Agents; Arthritis; Arthritis, Rheumatoid; Drug Administration Schedule; Fenoprofen; Humans; Ibuprofen; Naproxen; Prostaglandins; Sulindac; Tolmetin

Topics: Anti-Inflammatory Agents; Arthritis; Gold; Humans; Immunosuppressive Agents; Indomethacin; Penicillamine; Propionates; Quinolines; Steroids; Sulindac; Tolmetin

Topics: Arthritis; Humans; Indenes; Oxygen; Sulindac

Topics: Arthritis; Costs and Cost Analysis; Humans; Indenes; Sulindac

Topics: Advertising; Arthritis; Drug Industry; Humans; Indenes; Sulindac

Topics: Arthritis; Ethics; Humans; Indenes; Public Relations; Sulindac; United States

Topics: Arthritis; Drug Industry; Drug Information Services; Humans; Information Services; Public Relations; Sulindac; United States

Topics: Advertising; Arthritis; Attitude of Health Personnel; Drug Industry; Humans; Indenes; Public Relations; Sulindac; United States