Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A comparative controlled study was carried out in 40 patients suffering from rheumatoid arthritis, osteoarthrosis or ankylosing spondylitis to assess the efficacy of ketoprofen and ibuprofen. Patients were allocated at random to receive either 100 mg ketoprofen twice daily or 400 mg ibuprofen 3-times daily over a period of 3 months. Subjective overall assessments of symptoms, based on rating scale scores for pain, duration of morning stiffness and inflammation, showed that there was a greater, more rapid and more sustained improvement in those patients treated with ketoprofen. Measurements of inflamed joint size and of grip strength also improved more with ketoprofen than with ibuprofen. Side-effects, notably nausea, epigastric discomfort and abdominal pain, were more frequent and severe with ketoprofen, leading to the withdrawal of 2 patients in the early stage of the trial, and were probably related to the high dosage used. Three patients receiving ibuprofen needed 7 injections of ACTH to control their symptoms.
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PMID:A comparative trial of ketoprofen and ibuprofen in patients with rheumatic disease. 35 May

Etodolac is a nonsteroidal anti-inflammatory drug (NSAID) effective in the treatment of rheumatoid arthritis, osteoarthritis and ankylosing spondylitis, and in the alleviation of postoperative pain. Etodolac also provides relief of other types of pain, including that arising from gouty conditions and traumatic injury. In all indications, etodolac appears to be at least as effective as other NSAIDs. The incidence of clinical adverse effects other than abdominal pain and dyspepsia is similar to that observed with placebo, and etodolac has been associated with a low rate of gastrointestinal ulceration and other serious events. Data from preliminary animal studies have suggested that etodolac may provide more selective inhibition of prostaglandin synthesis at sites of inflammation than some other currently available NSAIDs. Thus, available evidence indicates that etodolac, with its low incidence of gastrointestinal events, is an effective and well tolerated alternative to other NSAIDs in the treatment of arthritic diseases and pain of various aetiologies and should be considered a first-line therapy.
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PMID:Etodolac. A reappraisal of its pharmacology and therapeutic use in rheumatic diseases and pain states. 171 25

The spondyloarthropathies of childhood present a diagnostic and therapeutic challenge. It is important to differentiate this group of arthritides from JRA because the nature and frequency of extra-articular complications are quite different, as is the prognosis and the therapeutic approach. JAS is the prototype of the spondyloarthropathies and probably accounts for greater than 75 per cent of all children with diseases included in this category. Unlike adult-onset ankylosing spondylitis, axial skeleton disease (sacroiliac, lumbar spine) is infrequent at onset of JAS and may not develop for months or years after the onset of arthritis in peripheral joints (particularly those of the lower extremity). Enthesitis, the inflammation of the insertion of tendon, capsule, ligament, or fascia to bone, is an important clinical diagnostic feature of this group of diseases. Extra-articular disease, such as rash in psoriatic arthritis, erythema nodosum, weight loss of abdominal pain (in the arthropathies of inflammatory bowel disease), urethritis, conjunctivitis, or Reiter's syndrome help to differentiate these spondyloarthropathies from JAS. Laboratory studies are of little assistance in differentiating JRA from the spondyloarthropathies except that in the latter group, RF is absent and HLA-B27 is frequently present. The high frequency of ANA in JRA contrasts with its corresponding low frequency in JAS. The long-term follow-up of chronic arthritis in childhood has demonstrated the variable and evolving nature of these conditions, and stresses the importance of continually questioning the accuracy of the diagnosis.
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PMID:Spondyloarthropathies of childhood. 376 52

During the past 2 years, we have encountered 14 patients whose onset of clinical symptoms of Crohn disease occurred after the age of 50, accounting for 14% of all Crohn disease patients studied in our department during this period. Most patients presented with diarrhea, abdominal pain, or perianal disease, and many also had anemia or rectal bleeding. The disease occurred slightly more often in the colon (n = 10), although many patients had terminal ileal disease (n = 7). The radiographic appearance was similar to that of Crohn disease in younger patients, with ulceration, fistula, and stricture formation. Occasionally, the disease mimics neoplasia or diverticulitis. Extraintestinal complications were also evident, with one patient each with renal calculi and ankylosing spondylitis. The occurrence of Crohn disease in the elderly is not uncommon, and a prompt diagnosis is important so that proper therapy can be initiated.
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PMID:Crohn disease in the elderly. 404 36

Patients with active ankylosing spondylitis of at least 6 months' duration were stabilised on diclofenac 50mg, given 2, 3 or 4 times daily in a 4-week open-label run-in. Patients were then randomised to receive a diclofenac 50mg/misoprostol 200 micrograms fixed combination tablet (n = 331) or diclofenac 50mg (n = 339) for 8 weeks at the same dosage frequency as in the open-label phase. For the intent-to-treat cohorts differences between treatment groups in the primary measures of efficacy were statistically significant. This between-group difference was thought to be attributable to the high incidence of 'unknown' outcomes, particularly in the diclofenac/misoprostol recipients. No significant differences were observed in the modified intention-to-treat or evaluable cohorts, which excluded patients with an 'unknown' outcome. No significant between group differences were observed in the change from baseline in the ankylosing spondylitis assessments. A difference was apparent between groups in the incidence of adverse events, particularly abdominal pain and diarrhoea (18.1 and 17.2%, respectively, in diclofenac/misoprostol recipients versus 12.4% each in diclofenac recipients). However, it was thought that the 4-week open-label phase of the study, during which patients received only diclofenac, may have selected for diclofenac-tolerant patients. Thus, in the treatment of ankylosing spondylitis, the diclofenac/misoprostol fixed tablet was as effective as diclofenac. Furthermore, diclofenac/misoprostol was well tolerated.
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PMID:Efficacy of diclofenac/misoprostol vs diclofenac in the treatment of ankylosing spondylitis. 768 85

The safety of a fixed combination of diclofenac 50mg/misoprostol 200 micrograms has been evaluated in clinical trials involving almost 2000 patients. Short term trials have been conducted in patients with osteoarthritis (n = 1032) and rheumatoid arthritis (n = 685) over 1 or 3 months. Patients randomly received either diclofenac alone or diclofenac/misoprostol. In both groups, the most frequently reported adverse events were gastrointestinal in nature, with abdominal pain reported most frequently (in 22.6% of patients receiving diclofenac/misoprostol and 19.8% of patients receiving diclofenac), followed by diarrhoea (19.5 vs 11.3%), nausea (11.0 vs 6.5%) and dyspepsia (10.6 vs 7.8%). The most frequent nongastrointestinal adverse event was headache, which occurred in 7.9% of diclofenac/misoprostol recipients and 9.3% of diclofenac recipients. Although diclofenac/misoprostol was associated with a slightly higher prevalence of adverse events than diclofenac in these studies, the majority were of mild or moderate severity, and the treatment groups were similar as regards the number of patient withdrawals resulting from adverse events. An interim analysis of the results of an ongoing trial of longer term administration of diclofenac/misoprostol (for up to 24 months) has been conducted. In this uncontrolled study, patients with rheumatoid arthritis, osteoarthritis or ankylosing spondylitis received diclofenac/misoprostol for up to 24 months; to date 1003 patients have been enrolled and treatment has been continued for 6, 12, 18 and 24 months in 640, 327, 108 and 13 patients, respectively. As in the short term trials, the adverse events reported most commonly in this study have been predominantly gastrointestinal.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Review of the safety of diclofenac/misoprostol. 768 86

The aim of the present study was to elucidate the connection between yersiniosis and chronic inflammation. During the period 1974-83, Yersinia enterocolitica infection was diagnosed in 458 hospitalized patients by antibody response, or isolation. The patients were followed for 4-14 years (1987); 160 were readmitted with chronic disease. Fifty-three patients had persistent joint complaints, 18 developed ankylosing spondylitis, 14 rheumatoid arthritis, and 17 iridocyclitis. Thirty-eight patients suffered from chronic abdominal pain, and another 28 from chronic diarrhoea. Two who underwent proctocolectomy microscopically had ulcerative colitis. Eleven patients developed neurological disease; others developed conditions such as chronic nephritis, thyroid disease, insulin-dependent diabetes, etc. Chronic hepatitis, found in 22 patients, was significantly correlated with positive test for antinuclear antibody and rheumatoid factor, and with death. Several patients developed chronic multiorgan disease, probably with chronic hepatitis as pivot. Regarding the whole material, the difference between observed and expected cumulative survival rates remained significant for 8 years (0.9189 < 0.9456; p < 0.025), indicating a substantial impact on long-term survival exerted by chronic yersiniosis.
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PMID:Yersinia enterocolitica: an inducer of chronic inflammation. 796 May 1

Juvenile ankylosing spondylitis (JAS) is a chronic inflammatory arthritis of the peripheral and axial skeleton, frequently accompanied by enthesitis. About four percent of patients with JAS have ulcerative colitis or Crohn's disease. Crohn's disease is the more common of the two and is diagnosed in 26 percent of patients with chronic spondyloarthropathy. In this paper, a 14-year-old male patient is presented as a typical case of juvenile ankylosing spondylitis and Crohn's disease with low back pain, morning stiffness, limited motion in anterior and lateral flexion and extension, left sacroiliitis, ankylosis in the apophyseal joints of the lumbar vertebrae, abdominal pain, bloody diarrhea, characteristic histopathologic changes of colonic involvement such as lymphoid follicles, fissures, submucosal polymorphonuclear cell infiltration and definite ganglion cells. The current therapy with mesalazin, having fewer side effects than sulfosalazin, and its applicability in combination with naproxen sodium is also discussed.
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PMID:A case of juvenile ankylosing spondylitis and Crohn's disease. 922 28

Secondary amyloidosis is an occasional complication of ankylosing spondylitis (AS) and in most cases renal amyloidosis presents with proteinuria, nephrotic syndrome and decreased renal function. We describe a 32-year-old male patient with AS manifested by frequent diarrhea, intermittent abdominal pain and low serum albumin levels. He has suffered from severe inflammatory back pain for 14 years with multiple peripheral joint involvement. Protein-losing enteropathy due to gastrointestinal amyloidosis was diagnosed with 99mTc-human albumin scintigraphy, fecal alpha-1 antitrypsin clearance and colonoscopic biopsy with Congo red staining. Somatostatin analogue octreotide and prednisolone were introduced with successful result.
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PMID:Successful treatment of protein-losing enteropathy due to AA amyloidosis with somatostatin analogue and high dose steroid in ankylosing spondylitis. 1107 6

Nabumetone is a nonsteroidal anti-inflammatory prodrug, which exerts its pharmacological effects via the metabolite 6-methoxy-2-naphthylacetic acid (6-MNA). Nabumetone itself is non-acidic and, following absorption, it undergoes extensive first-pass metabolism to form the main circulating active metabolite (6-MNA) which is a much more potent inhibitor of preferentially cyclo-oxygenase (COX)-2. The three major metabolic pathways of nabumetone are O-demethylation, reduction of the ketone to an alcohol, and an oxidative cleavage of the side-chain occurs to yield acetic acid derivatives. Essentially no unchanged nabumetone and < 1% of the major 6-MNA metabolite are excreted unchanged in the urine from which 80% of the dose can be recovered and another 10% in faeces. Nabumetone is clinically used mainly for the management of patients with osteoarthritis (OA) or rheumatoid arthritis (RA) to reduce pain and inflammation. The clinical efficacy of nabumetone has also been evaluated in patients with ankylosing spondylitis, soft tissue injuries and juvenile RA. The optimum oral dosage of nabumetone for OA patients is 1 g once daily, which is well tolerated. The therapeutic response is superior to placebo and similar to nonselective COX inhibitors. In RA patients, nabumetone 1 g at bedtime is optimal, but an additional 0.5-1 g can be administered in the morning for patients with persistent symptoms. In RA, nabumetone has shown a comparable clinical efficacy to aspirin (acetylsalicylic acid), diclofenac, piroxicam, ibuprofen and naproxen. Clinical trials and a decade of worldwide safety data and long-term postmarketing surveillance studies show that nabumetone is generally well tolerated. The most frequent adverse effects are those commonly seen with COX inhibitors, which include diarrhoea, dyspepsia, headache, abdominal pain and nausea. In common with other COX inhibitors, nabumetone may increase the risk of GI perforations, ulcerations and bleedings (PUBs). However, several studies show a low incidence of PUBs, and on a par with the numbers reported from studies with COX-2 selective inhibitors and considerably lower than for nonselective COX inhibitors. This has been attributed mainly to the non-acidic chemical properties of nabumetone but also to its COX-1/COX-2 inhibitor profile. Through its metabolite 6-MNA, nabumetone has a dose-related effect on platelet aggregation, but no effect on bleeding time in clinical studies. Furthermore, several short-term studies have shown little to no effect on renal function. Compared with COX-2 selective inhibitors, nabumetone exhibits similar anti-inflammatory and analgesic properties in patients with arthritis and there is no evidence of excess GI or other forms of complications to date.
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PMID:Nabumetone: therapeutic use and safety profile in the management of osteoarthritis and rheumatoid arthritis. 1545 29


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