Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0003873 (rheumatoid arthritis)
 53,068 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

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

Etodolac is a new nonsteroidal anti-inflammatory drug (NSAID) with potent analgesic and antiarthritic properties. The purpose of these randomized, double-blind, parallel-group studies was to compare etodolac with other standard NSAIDs or placebo for the treatment of rheumatoid arthritis, osteoarthritis, and ankylosing spondylitis. Results of rheumatoid arthritis and osteoarthritis studies showed etodolac (200 to 300 mg b.i.d. or 200 mg t.i.d.) to be comparable to naproxen (500 mg b.i.d.), piroxicam (20 mg once daily), and diclofenac (50 mg t.i.d.). Key efficacy variables improved significantly (p less than or equal to 0.05) in all treatment groups, and there were no significant between-group differences. Studies comparing etodolac (200 mg b.i.d.) with indomethacin (50 mg t.i.d.) for treatment of ankylosing spondylitis showed significant improvement from baseline in both the patient's and physician's global assessments for both treatments. Titrated-dose studies compared etodolac (50 to 200 mg b.i.d.) with naproxen (250 to 375 mg b.i.d.) and placebo for the treatment of ankylosing spondylitis. Both active drugs resulted in greater improvement than did placebo in the patient's and investigator's global assessments. These results indicate that etodolac is as effective as naproxen, piroxicam, and diclofenac for the treatment of rheumatoid arthritis and osteoarthritis. Moreover, it is comparable to naproxen and indomethacin and superior to placebo for the treatment of ankylosing spondylitis.
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PMID:An overview of the efficacy of etodolac in arthritic disorders. 214 30

Etodolac has been shown to have a favorable safety profile in short-term and long-term studies in both osteoarthritis (OA) and rheumatoid arthritis (RA). Two studies were conducted to further assess the gastrointestinal (GI) safety profile of this drug. These studies were designed to compare the therapeutic efficacy and upper GI effects of etodolac (600 mg/day) and naproxen (1000 mg/day) administered over 4 weeks in patients with active rheumatoid arthritis. In addition, the relative effects of the drugs on prostaglandin levels in the stomach and duodenum were assayed in one study. Fifteen patients were included in each study and received either 300 mg b.i.d. of etodolac or 500 mg b.i.d. of naproxen. In both studies, endoscopic examinations were performed on day 1 of the study and again 4 weeks later. In the second study, at the time of each endoscopy, samples of gastric and duodenal mucosa were taken for histologic study and prostaglandin assay. Endoscopy results from the first study showed significant differences in favor of etodolac between the two treatment groups. In the second study more naproxen-treated patients had abnormal endoscopy results than did etodolac-treated patients. Results from prostaglandin assays in gastric and duodenal mucosa showed no overall suppression of gastric or duodenal prostaglandin levels for etodolac-treated patients in contrast to naproxen-treated patients, who showed suppression of PGE2 and PGI2. The results of these studies show that etodolac therapy caused less gastric and duodenal injury than naproxen and also support the theory that the GI safety of etodolac may be due to selective sparing of cytoprotective prostaglandins.
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PMID:Endoscopic evaluation of etodolac and naproxen, and their relative effects on gastric and duodenal prostaglandins. 215 May 67

Etodolac is a new nonsteroidal anti-inflammatory drug (NSAID) that has shown a favorable safety profile in clinical trials in osteoarthritis (OA) and rheumatoid arthritis (RA). Four postmarketing surveillance studies were conducted with patients who had OA and RA to further assess the safety of etodolac. One study also had patients with ankylosing spondylitis (AKS). These studies were conducted in Italy, Switzerland, the United Kingdom, and France. A total of 8334 patients received oral doses of 200 to 600 mg/day for periods ranging from 4 weeks to 1 year. The incidence of study events was low, 77% of the patients treated in these postmarketing surveillance studies reported no study events. Only 9% of all the patients treated withdrew from these studies because of adverse effects. Gastrointestinal events were the most commonly reported among the study events that did occur, as expected for an NSAID. These results further support the safety of etodolac that was previously established in clinical trials.
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PMID:Global safety of etodolac: reports from worldwide postmarketing surveillance studies. 215 May 68

Two large-scale open-label studies were performed in France to confirm the efficacy and safety of etodolac (Lodine), a new non-steroidal anti-inflammatory drug (NSAID). Study I, a 6-week study performed by 974 rheumatologists, involved 4947 patients who had rheumatoid arthritis (RA), ankylosing spondylitis (AS), or osteoarthritis (OA). Both efficacy and safety were assessed. Study II, a postmarketing safety study performed by approximately 9000 general practitioners, involved 51,355 patients who had rheumatic conditions requiring therapy with NSAIDs. The daily dose of etodolac ranged from 200 to 600 mg/day in these studies, depending on the protocol and patient response. By the end of study I (visit 3), spontaneous pain improved by 33% for patients with RA, by 42% for patients with AS, and by 50% for OA patients. A total of 1276 adverse reactions (AR) were reported during the study, and fewer than half of these were related to study treatment. Only 6 severe reactions were reported; three of these were considered unrelated to study treatment, including 2 deaths. In study II, 10.1% of patients reported 6236 ARs and 9.0% of patients dropped out because of AR. Twenty-one of the ARs reported in study II were judged severe, and all of these patients recovered completely. The overall opinion of safety was assessed as very good or good by 89% of patients. In both studies (greater than 55,000 patients), 11% of patients reported an AR, and severe reactions were rare. These results confirmed the very acceptable risk/benefit ratio of etodolac and rank this drug high for efficacy and safety among the NSAIDs recently introduced in France.
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PMID:Large-scale open trials with etodolac (Lodine) in France: an assessment of safety. 215 May 69

Cultures of human rheumatoid synovial cells and rabbit articular chondrocytes were exposed to various concentrations of Etodolac (from 0.01 to 10 micrograms/ml) in presence or absence of 500 pg/ml (5 U/ml) human recombinant Interleukin-1 beta (IL-1 beta). Incubation of chondrocytes with Etodolac for 24 h did not alter collagen biosynthesis. In contrast, 1 micrograms/ml Etodolac caused a 20% increase of collagen production in synoviocytes. Addition of Etodolac in combination with IL-1 could partially suppress the inhibitory effect exerted by the cytokine on both cell types. Four-day exposure of chondrocytes to 0.1 and 1 micrograms/ml Etodolac led to an increased accumulation of collagen in the cell layer compartment. However, this treatment could not prevent the inhibitory effect of IL-1 on this collagen fraction. Treatment of synoviocytes for eight days with the same concentrations of Etodolac did not modify their collagen production but suppressed totally the inhibitory effect of IL-1. These data show that Etodolac is able to augment chondrocyte metabolism during a long term treatment. Moreover, under certain conditions, this drug can reduce or even suppress the IL-1-induced inhibition of collagen biosynthesis, a process that may take a part in the connective tissue alterations associated with osteoarticular diseases such as rheumatoid arthritis and osteoarthritis.
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PMID:Modulation of extracellular matrix metabolism in rabbit articular chondrocytes and human rheumatoid synovial cells by the non-steroidal anti-inflammatory drug etodolac. I: Collagen synthesis. 215 Jul 40

Efficacy, safety and therapeutic benefit of etodolac (Lodine 200) in rheumatological practice. An open clinical trial performed by 974 rheumatologists enabled an evaluation of efficacy, safety and therapeutic benefit of etodolac (Lodine 200) on 4,947 patients with rheumatoid arthritis, ankylosing spondylitis and osteoarthritis of the lower limbs; the initial dosage was 600 mg/d (for 2 weeks), then 400 to 600 mg/d (for 2 to 4 weeks, according to the indication). Efficacy, assessed by classical items for NSAID's, was shown to be excellent to good by 61-77 p. 100 of patients, according to the indication. 7.7 p. 100 of patients only dropped out for lack of efficacy. 20.4 p. 100 of patients developed adverse effect(s) (AE), but the relationship between etodolac and AE was assessed "possible" or "probable" only for 9.6 p. 100 of patients; this figure should be compared to the 7.6 p. 100 of patients who dropped out for AE and to the 92 p. 100 of patients who assessed the global safety as "excellent or good". The therapeutic benefit was estimated very favorable: 75 p. 100 of patients felt better than at the beginning of the study, 64.5 p. 100 of patients wished to continue the treatment and the (mean) benefit-risk ratio assessed with a logarithm scale (-1 to +1), ranged from 0.45 to 0.6 according to the indication. Therefore, this trial confirmed the good efficacy and safety profile of etodolac on a large scale in normal clinical practice in France, following assessments during controlled trials. It also permitted to perfect new items of evaluation for NSAID's, in particular for therapeutic benefit.
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PMID:[Efficacy, tolerability and therapeutic benefit of etodolac (Lodine 200) in rheumatologic practice]. 252

The therapeutic efficacy and upper gastrointestinal side effects of a twice daily dose of 300 mg etodolac and 500 mg naproxen were compared in 30 hospital out-patients with active rheumatoid arthritis. Drugs were taken for 4 weeks in a double-blind, randomized, parallel group, single centre study. Rheumatological, endoscopic and laboratory assessments were performed at the start and on completion of the study. Mucosal lesions developed in only three (20%) patients of the etodolac group and they all had low endoscopy scores, compared to eight (53%) patients of the naproxen group with significantly worse endoscopy scores (p less than 0.05). Lesions were asymptomatic in all but one patient (on naproxen), and the gastric antrum was the commonest region involved. Of the 11 patients who developed endoscopic abnormalities in both groups, seven (64%) were moderate to heavy smokers. Etodolac had a similar antiarthritic effect to naproxen, but it appears to be better tolerated by the upper gastrointestinal mucosa as shown by endoscopy.
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PMID:Evaluation of the efficacy and comparative effects on gastric and duodenal mucosa of etodolac and naproxen in patients with rheumatoid arthritis using endoscopy. 252 43

Etodolac (Lodine, Ramodar, Ultradol), an anti-inflammatory, analgesic agent, is the first of a new class of nonsteroidal anti-inflammatory drugs (NSAIDs), the pyranocarboxylic acids. A review of the literature on numerous clinical studies showed that etodolac (200 to 600 mg/day) is effective in the treatment of osteoarthritis and rheumatoid arthritis. Etodolac has also been shown to be very well tolerated. In double-blind studies, there were no significant differences in the incidences of new patient complaints except for indigestion between etodolac-treated groups and placebo-treated groups. Gastrointestinal microbleeding associated with etodolac was comparable to that with placebo and was significantly less than that associated with other commonly used NSAIDs, such as ibuprofen, indomethacin, piroxicam, and naproxen. The results of laboratory tests, including a detailed analysis of hepatic and renal function, have revealed few abnormalities, most of which were clinically unimportant. When administered to healthy subjects, etodolac had no pharmacokinetic interactions with three other drugs that are highly bound to serum protein: warfarin, glyburide, and phenytoin.
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PMID:A review of the antiarthritic efficacy and safety of etodolac. 252 82

Etodolac, a nonsteroidal anti-inflammatory drug (NSAID) of the pyranocarboxylic acid family, has been tested in international clinical trials as a therapy for rheumatoid arthritis (RA). Preliminary results of 8- to 12-week double-blind trials indicate that etodolac therapy (200 mg twice a day) compared favorably with piroxicam therapy (20 mg once a day) and diclofenac therapy (50 mg three times a day) as measured by improvement in scores of five efficacy assessments: number of painful joints, number of swollen joints, physician's global assessment, patient's global assessment, and pain intensity. Etodolac also was as effective as naproxen (500 mg twice a day) as measured by improvement in scores in the five efficacy assessments. The observation that etodolac is as efficacious as three commonly used NSAIDs should interest clinicians who attempt to tailor NSAID therapy to the needs of individual RA patients, since etodolac has previously demonstrated an excellent safety profile. However, these trials must be completed to verify these preliminary results in a greater number of patients.
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PMID:International experience with etodolac therapy for rheumatoid arthritis: an interim report of comparative efficacy. 252 85


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