Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0013395 (dyspepsia)
 4,879 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Thirty-six patients suffering from rheumatoid arthritis took part in a double-blind crossover trial, in which they received either indoprofen 800 mg/day, naproxen 500 mg/day, or a matching placebo. Indoprofen was shown to be significantly superior as an analgesic and in improving grip strength and the patients preferred it. Adverse effects were comparable, although indigestion was seen slightly more often during indoprofen treatment. Indoprofen is therefore at least as effective as existing anti-inflammatory drugs in rheumatoid arthritis and seems to be better tolerated.
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PMID:Indoprofen and naproxen in the treatment of rheumatoid arthritis: a clinical trial. 34 6

73 patients with definite active rheumatoid arthritis were treated with naproxen, 250 mg b.i.d. One month after the start of therapy the patients were examined as to following parameters: spontaneous pain and pain on movement, duration of morning stiffness, fatigue, grip strength, functional joint index, ESR and consumption of analgesics. On statistical analysis a significant improvement of all the parameters, with the exception of ESR was shown, 52 of the 73 patients were very satisfied resp. satisfied with the treatment, whereas the physician evaluated the therapeutic results as very good to good in 49 of the cases. In 50 of the patients the therapy with naproxen, 250 mg b.i.d., was continued for two more months. In most of these cases it was possible to achieve an additional improvement in the parameters evaluated. Unwanted side effects occurred in 7 patients, of which in 4 the treatment had to be discontinued (in two cases because of dyspepsia and once each because of an angioneurotic edema and a recurrence of a peptic ulcer, respectively). The three patients in whose cases therapy was continued suffered from mild gastrointestinal disturbances.
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PMID:[Treatment of progressive chronic polyarthritis with a non-steroidal antirheumatic agent with a long half-life]. 44 68

To assess toxicity of D-penicillamine a retrospective chart review was performed on 63 patients with rheumatoid arthritis receiving penicillamine. These patients had a total of 83 courses of therapy. The mean age of patients was 52 years and the mean duration of disease was 10.07 years. Laboratory data showed an increase in hematocrit values from 36 per cent to 40 per cent and a decrease in the erythrocyte sedimentation rate from an average of 50 to 29 mm/hour. The platelet count also decreased with treatment from 394,000 to 267,000/mm3. The over-all complication rate was 53 per cent. Life-threatening complications occurred in two patients including one case of aplastic anemia and one case of nephrotic syndrome. One additional patient was referred with aplastic anemia. Minor complications include rash in 18 per cent, loss of taste in 6 per cent, dyspepsia in 11 per cent, oral ulceration in 7 per cent and proteinuria of less than 3 g/day in 8 per cent. In summary, 53 per cent of the courses of penicillamine were associated with toxicity including one episode of aplastic anemia and one case of nephrotic syndrome. Therapy was stopped due to complications in 39 per cent of the patients in this series.
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PMID:Toxicity of D-penicillamine in rheumatoid arthritis. A report of 63 patients including two with aplastic anemia and one with the nephrotic syndrome. 62 27

Indomethacin, 100 mg orally, was compared with prednisolone, 5 mg, as addititional therapy at night, in a two-week, double-blind, between-patient study in twenty-four in-patients with rheumatoid arthritis. Both therapies proved equally effective, and significantly lessened morning stiffness and increased grip strenght. Two patients with dyspepsia were discontinued from the indomethacin group. Using indomethacin at night avoided the central nervous system side-effects frequently seen with this compound.
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PMID:Indomethacin or prednisolone at night in rheumatoid arthritis? 73 14

In a 6-week open study in 24 patients with rheumatoid arthritis, tolmetin was shown to have analgesic and anti-inflammatory activity at daily doses in excess of 1200 mg per day and produced statistically significant reductions in overall joint pain, walking time and articular index. The drug was well tolerated, but 2 patients were withdrawn because of persistent indigestion and 1 because of an urticarial type rash. In a double-blind crossover comparison against indomethacin and placebo in 22 patients, 1400 mg tolmetin daily showed efficacy comparable with that of 150 mg indomethacin daily. Few side-effects were reported and did not necessitate any patients being withdrawn.
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PMID:Evaluation of tolmetin in the treatment of arthritis: open and controlled double-blind studies. 77 39

Attitudes to prescribing anti-inflammatory drugs have changed considerably over the last 25 years and there is now a recognition of the need to balance effectiveness with reduced risks of serious adverse reactions. Such serious side-effects often involve the upper gastrointestinal tract, and there are differences between anti-inflammatory drugs in the frequency with which they cause significant problems at this site. Anti-inflammatory drugs with a lesser propensity to cause gastrointestinal reactions may have an advantage. Several risk factors may be important for upper gastrointestinal side-effects including sex, age, history of dyspepsia, other diseases and the type of arthritis. Results from post-marketing surveillance studies of nabumetone in the United Kingdom and the Federal Republic of Germany showed that although patients with a previous history of dyspepsia were more likely to stop the drug due to an adverse reaction, the majority continued without any problem. Interestingly, patients with rheumatoid arthritis were more likely to stop therapy due to side-effects, though it was not clear if this was due to their disease or to multi-morbidity. Strategies are needed when prescribing anti-inflammatory drugs which take into account the type of patient, their disease, and the best drug. In many instances this could be nabumetone.
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PMID:A rheumatologist's viewpoint. 136 82

Data from four double-blind studies of the treatment of patients with rheumatoid arthritis or osteoarthritis were combined. For 4 to 12 weeks, 747 patients received Arthrotec, a combination of 50 mg of diclofenac and 200 micrograms of misoprostol, and 754 patients received 50 mg of diclofenac; the drugs were given twice or three times daily. The five most commonly reported adverse events were abdominal pain by 23.2% of the diclofenac/misoprostol patients and 19.8% of the diclofenac patients; diarrhea by 19.9% and 11.3%; nausea by 11.8% and 6.5%; dyspepsia by 11.2% and 7.8%; and flatulence by 8.0% and 3.1%. Other adverse events, reported by similar proportions of both treatment groups, included headache, gastritis, dizziness, vomiting, and constipation. In the diclofenac/misoprostol-treated patients, the abdominal pain and diarrhea were rated mild in 30.6% and 24.3%, moderate in 49.1% and 51.4%, and severe in 20.2% and 24.3%. Serious adverse events occurred in eight of the diclofenac/misoprostol-treated patients and in 13 of the diclofenac-treated patients; 12.6% and 10.1%, respectively, were withdrawn from the study because of adverse events. Results of laboratory tests of hepatic and renal function were similar in the two treatment groups.
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PMID:Overall safety of Arthrotec. 143 22

To evaluate the association of Helicobacter pylori infection with gastroduodenal ulceration and symptoms in rheumatoid arthritis patients chronically ingesting nonsteroidal anti-inflammatory drugs (NSAIDs), a population-based study was performed. Residents of Olmsted County, Minnesota, and surrounding counties, 40 years of age and over with active rheumatoid arthritis taking therapeutic dose of NSAIDs daily for 6 months or more were evaluated (n = 50). An endoscopic score from 0 to 5 was assigned and independently confirmed. Biopsies were obtained from the antrum and gastric body for the presence of H. pylori. A symptom score based on the frequency and severity of dyspeptic symptoms was calculated. Substantial mucosal injury (greater than or equal to grade 2) was observed at endoscopy in 33 patients (66%); 14 (28%) had chronic ulcers. Eleven of the community patients with rheumatoid arthritis (22%) were H. pylori positive; adjusting for age, the prevalence of H. pylori was not significantly different to that in 67 health controls (25%). One or more upper gastrointestinal symptoms were reported by 19 of the community patients (38%). Adjusting for age, community rheumatoid arthritis patients with H. pylori were not more likely to have visible mucosal damage or dyspepsia, but were significantly more likely to have histological gastritis (P less than 0.01). The results suggest that, in primarily asymptomatic persons from the community with rheumatoid arthritis taking daily NSAIDs for 6 months or more, H. pylori infection is not related to the severity of visible mucosal injury.
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PMID:Long-term nonsteroidal anti-inflammatory drug use and gastroduodenal injury: the role of Helicobacter pylori. 158 9

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 aim of this clinical, endoscopical study was to evaluate the therapeutic efficacy and the gastric tolerability of etodolac, a new anti-inflammatory, non-steroidal drug, compared with naproxen. The study was conducted on 48 patients suffering from rheumatoid arthritis. 44 of whom completed the trial. After an initial oesophagogastroduodenoscopy to exclude the presence of gastric mucosal lesions, patients were randomly allocated to double-blind treatment with either etodolac 200 mg b.i.d. or naproxen 500 mg b.i.d. for a period of 4 weeks. Endoscopic control followed this treatment period. Both drugs proved effective in relieving clinical symptoms, without a statistically significant difference. Gastric mucosal lesions were observed in 15% of etodolac-treated patients and in 46% of patients treated with naproxen (P less than 0.05) (95% CI 0.01-0.60). Painful dyspepsia was observed in 15% of patients treated with etodolac vs. 38% of patients on naproxen therapy. This study demonstrates that etodolac is at least as active as naproxen in relieving rheumatic symptoms, and its administration results in a significantly lower degree of gastric damage.
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PMID:A double-blind gastroscopic evaluation of the effects of etodolac and naproxen on the gastrointestinal mucosa of rheumatic patients. 182 23


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