Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Thirty-nine Caucasian women with definite or probable ankylosing spondylitis were tissue typed and the radiographic and clinical features were correlated with the presence of B27 (formerly W27). This investigation showed that the same strong positive correlation observed in men obtains in women between B27 and unequivocal radiographic changes. As such changes develop slowly in women, clinical and laboratory features were identified which were sufficiently characteristic to enable the diagnosis to be reached in advance of decreased spinal mobility. Immobility pain and stiffness and bilateral sacroiliac pain are the most characteristic features, but additional support is provided by the presence of any of the following: onset by age 30, a raised sedimentation rate, peripheral joint involvement, circumthoracic pain, family history, and iritis.
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PMID:Clinical diagnosis of ankylosing spondylitis in women and relation to presence of HLA-B27. 98 7

Participation in open and double-blind crossover studies in rheumatoid arthritis confirmed that naproxen improved pain and stiffness. This observation suggested that naproxen might be effective in ankylosing spondylitis. The initial trial was open, but at six months, a double-blind crossover "placebo pulse" was superimposed on the open trial. Thirty-six patients entered the trial taking a daily dose of 500 mg naproxen. At the end of the first month, 35 assessed naproxen as being equally effective to, or better than, previous therapy. The first ten patients to complete six months on naproxen took part in a placebo pulse study comprising two consecutive four-week periods, in one of which each patient took 500 mg naproxen, in the other, identical placebo capsules, the order being randomized. Eight patients correctly identified the placebo capsules (P=0.02). During the 16 months of trial, six patients have withdrawn, two being in remission and four for lack of efficacy. The remaining 30 patients have completed six months and 22 have completed at least 12 months on naproxen. At the end of six months pain was less (P=0.02), morning stiffness had decreased (P less than 0.01), and immobility stiffness had improved (P less than 0.01). These patients are impressed by the improvement in pain and stiffness and have little disability. All continue full-time employment and have been able to increase their leisure activities without discomfort. No persistent side effects were observed, and naproxen appears to be a useful drug in the treatment of anklyosing spondylitis.
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PMID:Ankylosing spondylitis: open long-term and double-blind crossover studies with naproxen. 109 29

The methodology of documenting clinical findings and statistical analysis of the results of a multicentre double-blind cross-over study, in which the efficacy of d-2-(6'-methoxy-2'-naphthyl)-propionic acid (naproxen) and indometacin in the treatment of rheumatic diseases was compared, is presented. Eight investigators from four clinics conducted this clinical trial according to an identical protocol in a total of 100 patients. 46 patients (5 male and 31 female) with rheumatoid arthritis received either of the two drugs over a period of 26 days. 35 patients (32 male and 3 female) with ankylosing spondylitis and 19 patients (8 male and 11 female) with osteoarthrosis were treated with either of the drugs for 15 days. The following parameters were investigated and documented: pain and its localization, inhibition of joint function, symptoms of inflammation, and the "quasi" irreversible joint changes. These various parameters were for statistical purposes combined as indices for pain, function, and inflammation. This permitted a quantitative evaluation of the analgesic and antiinflammatory efficacy as well as of the improvement of joint function of the two compounds tested. The overall results of the clinical parameters revealed no significant difference in efficacy for the two drugs. When differentiating the patients as to their sex, both drugs showed higher efficacy in male patients, and only slight efficacy in female patients.
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PMID:[Methods and statistics of multicentral double-blind "cross-over" examination of naproxen compared to indomethacin]. 109 2

In a multicenter double-blind cross-over trial the therapeutic effect and the tolerance of d-2-(6'-methoxy-2'-naphthyl)-propionic acid (naproxen) and indometacin were compared including 46 patients with rheumatoid arthritis, 35 patients with ankylosing spondylitis and 19 patients with osteoarthrosis. Duration of treatment with both drugs was two to four weeks each. The daily dose of naproxen was 750 mg, that of indometacin l50 mg. In rheumatoid arthritis the combined clinical effect of indometacin was stronger than that of naproxen while both drugs had the same clinical effectiveness in ankylosing spondylitis and osteoarthrosis. When differentiating the total clinical effect as to indices of pain, inflammation and function, indometacin was shown to be superior in all three diseases with regard to pain index. On the other hand, naproxen showed a better effect in ankylosing spondylitis and osteoarthrosis than indometacin as to inflammation, and as to function in osteoarthrosis.
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PMID:[Clinical results of a multicentral double-blind examination of naproxen compared to indomethacin in chronic rheumatoid arthritis, ankylosing spondylitis, and osteoarthrosis]. 109 3

27 patients with ascertained ankylosing spondylitis experiencing constant after-midnight-pain received, following three medication-free days, in a double blind, randomized, cross-over fashion indometacin (100 g/day) and d-2-(6'-methoxy-2'-naphthyl)-propionic acid (naproxen) (500 mg/day), as suppositories, for a period of six days each. The intensity of the night-pain was recorded daily. Naproxen was shown to be equally effective as indometacin in alleviating the after-midnight backache of ankylosing spondylitis. Side effects occurred under indometacin in 5 cases, under naproxen in 3 cases.
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PMID:[A double blind comparison of naproxen and indomethacin on the after-midnight-pain of patients with morbus bechterew]. 109 4

The administration of drugs constitutes an important component of the therapeutic programme in ankylosing spondylitis (AS). The main objective of initiating such therapy is to reduce pain, stiffness and discomfort. There are at present 3 groups of drugs available for the management of AS. The first group is represented by drugs thought to influence the disease process itself. In this group, sulfasalazine is the only drug which is controlled trials has been shown to suppress disease activity in AS. We recommend the use of sulfasalazine in patients with high disease activity, with peripheral arthritis and in those with AS of short duration. The second group of drugs includes nonsteroidal anti-inflammatory drugs (NSAIDs), which suppress inflammation without influencing the disease process. These drugs should be administered selectively during periods of high disease activity. Moreover, 1 drug should be used in appropriate dosage before it is assumed to be inefficient. High doses of NSAIDs may be prescribed before bedtime in patients suffering from severe pain and stiffness during the night. The toxicity profile of NSAIDs includes gastrointestinal and renal side effects. The third group comprises analgesics and muscle relaxants. Such drugs should be used rather frequently in patients with longstanding AS refractory to treatment with NSAIDs. Peripheral arthritis and enthesopathy are generally managed by local injections of corticosteroids, while AS complicated by psoriasis or inflammatory bowel disease is treated as primary AS. AS occurring in juveniles is best treated with aspirin and an NSAID, although careful observation is necessary for the development of Reye's syndrome (with aspirin) and gastric irritation (with NSAIDs). When patients with AS undergo surgery, the possibility of silent gastrointestinal bleeding due to the use of NSAIDs and salicylates should not be ignored. Patients treated with oral corticosteroids should receive a bolus injection of soluble corticosteroid prior to surgical intervention. NSAIDs may be administered pre- and postoperatively to relieve stiffness induced by immobility. Rapid treatment of intervening infections and use of NSAIDs is recommended in AS complicated by renal amyloidosis. During pregnancy and lactation, ibuprofen may be the preferred drug in AS.
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PMID:Ankylosing spondylitis. Current drug treatment. 128 Oct 74

Thirty-nine patients with ankylosing spondylitis participated in a randomized, double-blind, double-dummy, multi-cross-over study with enteric-coated (ECT) and plain (PT) naproxen tablets. The duration of the study was 24 days with 6 treatment periods of 4 days. The majority of the patients were taking 750 mg naproxen daily. The mean plasma concentration of naproxen in the morning was 36% higher with ECT (p < 0.001). No significant differences regarding duration of morning stiffness and night time pain were found in this patient category. The mean duration of morning stiffness was 116 minutes (ECT) and 125 minutes (PT). We were not able to show correlation between plasma concentration of naproxen and duration of morning stiffness.
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PMID:Morning stiffness and nightime pain in ankylosing spondylitis. A comparison between enteric-coated and plain naproxen tablets. 136 37

Forty-two patients with ankylosing spondylitis were entered into a double-blind study to compare treatment with indomethacin and a new non-steroidal anti-inflammatory drug, nabumetone. Clinical, laboratory and side-effect profiles were measured over a three month period. Both drugs were effective in relieving pain and morning stiffness, indomethacin was better in alleviating general stiffness, nabumetone resulted in less side-effects. Objective measurements of spinal movements revealed no difference between the two drugs. Nabumetone, available as Relifex, appears as effective as indomethacin in relieving the symptoms of ankylosing spondylitis and is possibly better tolerated.
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PMID:A comparative study of nabumetone and indomethacin in ankylosing spondylitis. 136 69

Twenty-nine temporomandibular joints (TMJs) in 19 patients with chronic arthritic disease were surgically treated. Nine patients had rheumatoid arthritis (including two with juvenile type), six had ankylosing spondylitis and four had psoriatic arthropathy. Using a preauricular approach, diskectomies with synovectomies were performed in 23 joints (14 patients) with chronic arthritic abnormalities. Diskectomies without synovectomies were performed in six joints (five patients), which proved to have internal derangements unrelated to their chronic arthritic disease. Joints with chronic arthritis showed considerable variation in inflammatory reactions, but were characterized by increased vascularization, synovial proliferation to the articulating surfaces and mostly pannus formation and bone resorption. A response in pain relief was seen in 85% of the patients three months postoperatively and in 79% of the patients 12 months postoperatively, indicating that diskectomy with synovectomy may be favorable in patients with severe TMJ problems due to involvement of chronic arthritic disease.
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PMID:Surgical treatment of temporomandibular joints in patients with chronic arthritic disease: preoperative findings and one-year follow-up. 142 82

In the Rheumatological Institute in Prague the authors made a retrospective investigation in patients with ankylosing spondylitis affecting the hip joints where one or two endoprostheses of the hip joints were made. In all these patients they evaluated the subjective complaints of the operated extremity, they made a clinical examination of the extent of mobility and evaluated X-ray pictures. The group of 20 patients was examined in this retrospective investigation approximately five years after operation. From the total of 32 endoprostheses 20 were cemented and 12 were without cement. From the total number of patients only four reported slight pain in the area of the operated hip joint without signs of loosening on the X-ray picture. The extent of mobility of all endoprostheses was very satisfactory, the mean abduction in men was 27.6 degrees, in women 30.7 degrees, flexion 84 degrees in men and 97 degrees in women. As revealed by X-ray, the hip joints were affected most frequently by coxitis, osteoplastic changes were detected in six patients. Enthesopathies of a small or medium extent were found in almost all patients. Heteroplastic bone was evaluated according to Brooker's criteria, in the investigated group only type I was found. It may be stated that the submitted group of results of endoprostheses in ankylosing spondylitis is a very satisfactory solution which improves the patient's mobility and thus restores the quality of life.
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PMID:[Replacement of hip joints with total endoprostheses in patients with ankylosing spondylitis]. 146 76


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