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)

The author submits the results of Feldene gel therapy which contains 5 mg piroxicam per 1 g. The preparation was applied to patients with deforming gonarthrosis, always on one joint three times per day for two weeks. The evaluation was made before the unset of treatment and on the 7th and 14th day. It was an open clinical therapeutic trial. In 97.5% the tolerance was excellent. Undesirable manifestations developed only in one female patients who had sensations of irritation which disappeared in three days and interruption of treatment was not necessary. The authors evaluated pain, mobility, required assistance during change of position-sitting and standing up and when climbing stairs. The evaluation was made by the physician and the patient. Significant results were achieved in particular as regards pain but also in the other parameters. In more than 90% regression of all evaluated criteria was recorded. The preparation is evaluated very favourably. It helps not only in treatment proper but has also a comprehensive effect. Feldene gel is an important asset to local treatment in rheumatology and will be most probably valuable also in orthopaedics, surgery and sports medicine.
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PMID:[Feldene in local therapy of deforming gonarthroses]. 159 3

One hundred and thirty-one patients with osteoarthritis of the knee or hip entered a comparative trial of sustained release (SR) ibuprofen ('Fenbid') and piroxicam ('Feldene'). Paracetamol was provided as 'escape' medication. During the 3 week treatment period the patients assessed pain and stiffness in either the knee or hip as well as general joint pain and stiffness and duration of morning stiffness, overall wellbeing, sleep disturbance and paracetamol consumption. Physicians assessed response to joint manipulation and the function of the joint subjectively. The results were statistically compared with those from a run-in period during which only paracetamol was given. Over the trial period significant improvement was noted in all of the parameters with both treatments. SR ibuprofen was significantly better than piroxicam at reducing morning stiffness. In addition fewer patients taking ibuprofen experienced upper gastrointestinal symptoms, 4% compared to 20% taking piroxicam.
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PMID:Is sustained-release ibuprofen as effective as piroxicam? A comparison in patients with osteoarthritis. 640 May 21

General Practitioners from the United Kingdom produced data on 1,282 patients with acute soft tissue injury treated with either piroxicam (Feldene) or matching placebo for a period of up to two weeks. The dosage of piroxicam was 40 mg for the first 2 days and 20 mg daily thereafter. Clinical assessment included pain, swelling, limitation of active and passive movement and overall assessment of efficacy and toleration. Piroxicam was significantly better than placebo in improving patient signs and symptoms, and in its overall efficacy (P less than 0.001); 87% of piroxicam treated patients had excellent or good responses, compared to 53% of placebo treated patients. On analysis of four of the most commonly occurring diagnoses (injuries of ankle, knee, shoulder, back) patients with moderate or severe pain showed a significant improvement on treatment with piroxicam. Physicians' overall assessment of toleration showed no evidence of differences between treatments. Over 90% of patients in both treatment groups had good or excellent toleration. Withdrawals due to side effects were 3% and 2.5% respectively for piroxicam and placebo treated patients.
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PMID:A double blind, placebo controlled study of piroxicam in the management of acute musculoskeletal disorders. 644 59

A patient with chronic rheumatoid arthritis under treatment with steroids was given piroxicam (Feldene) for relief of pain and disability. Overt cutaneous and occult gastrointestinal bleeding developed after two months of treatment. Bleeding subsided and laboratory values returned to normal upon discontinuation of the drug.
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PMID:Bleeding tendency possibly related to increased plasma antithrombin III activity in patient treated with piroxicam. 660 35

A multicentre trial involving 1350 patients evaluated by 310 practitioners throughout South Africa was conducted to determine whether overseas studies relating to the efficacy and toleration of piroxicam (Feldene; Pfizer) would be confirmed in the local environment. Piroxicam, a member of a new class of non-steroidal anti-inflammatory agents, possesses a long plasma half-life permitting a once-a-day dosage regimen in osteo-arthrosis, rheumatoid arthritis, ankylosing spondylitis, acute musculoskeletal disorders and acute gout. In this study it was found to provide significant relief of pain and stiffness and to have a relatively low side-effect profile, confirming that it is a useful addition to current non-steroidal anti-inflammatory drug therapy.
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PMID:An evaluation of piroxicam, a new non-steroidal anti-inflammatory agent. A multicentre trial. 701 42

Osteoarthritis is the most common joint disease and the second highest ranking cause of disability in the US. Osteoarthritis commonly affects the hands, wrists, spine, knees, and feet. One of the mainstays of treatment for osteoarthritis is the use of nonsteroidal anti-inflammatory drugs. While there have been controlled comparison studies of the various nonsteroidal anti-inflammatory drugs, these have been limited to osteoarthritis of the hands, spine, and hip. This study was a randomized, double-blind, parallel study of 8 weeks' duration comparing piroxicam (Feldene, 20 mg daily) to naproxen (Naprosyn, 1,000 mg daily) in the treatment of osteoarthritis of the foot in 45 patients. Both groups experienced significant pain relief and improvement of mobility.
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PMID:Comparison of piroxicam and naproxen in osteoarthritis of the foot. 806 97

The aim of the present study was to compare the analgesic efficacy of piroxicam-FDDF (fast dissolving dosage form) with naproxen sodium, following bilateral removal of impacted third molars. A double-blind, randomized, crossover, analgesic trial was carried out on 40 patients undergoing surgical removal of one lower third molar at each visit. The analgesic efficacy of a single dose regimen of piroxicam-FDDF (40 mg, Feldene Flash, Pfizer, Turkey) was compared with naproxen sodium (550 mg, Anaprotab, Sanli, Turkey). Pain intensity was measured on a category-rating scale during the 8-h period after drug administration. Each patient evaluated the efficacy of the study medication at 15, 30, 45, 60, 90 and 120 min, and then hourly for up to 8 h of drug ingestion. Additional key efficacy measures were also determined (pain intensity difference [PID], sums of pain intensity difference [SPID], total pain relief [TOTPAR], peak pain relief, number of observations at which pain was half-relieved, overall evaluation of study medication effectiveness, and time to medication with a back-up analgesic). The data were analyzed by paired Student's t-test and one-way analysis of variance (ANOVA). Results are expressed as means +/- SEM, and p < 0.05 was taken as statistically significant. The PID and pain relief scores of the piroxicam-FDDF group were significantly greater than those for the naproxen sodium group at 15, 30, 45 and 60 min (p < 0.01). After 90 min to 8 h, no statistical significance was revealed among the two test groups (p > 0.05). The peak pain relief, maximal analgesic effect, SPID, TOTPAR values, adjusted mean number of observations with pain at least half-relieved, and the final overall evaluation records were all superior for piroxicam-FDDF (p < 0.05). The results of this study clearly show that the analgesic efficacy of piroxicam-FDDF is superior to naproxen sodium in the treatment of pain following oral surgery for the removal of impacted third molars.
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PMID:The postoperative analgesic efficacy and safety of piroxicam (FDDF) and naproxen sodium. 960 31

Piroxicam (Feldene) is indicated for osteoarthritis and rheumatoid arthritis but not analgesia due to its delayed onset of pain relief. Piroxicam-beta-cyclodextrin (PBCD) was developed for pain indication by virtue of the increased absorption rate of piroxicam. Forty-eight patients received a single dose of PBCD or Feldene (10, 20, and 40 mg) in a randomized study, and piroxicam plasma concentration and pain relief were measured. The purpose of the study was to investigate the PK-PD relationship of piroxicam, determine the optimal dose, and evaluate the effect of increased absorption rate on analgesic effect of piroxicam for the pain model studied. The pharmacokinetic data were best described by a two-compartment model with first-order absorption. The absorption rate of PBCD (5/h) was faster than Feldene (1.41/h). Pain relief was found to be increasing with drug concentration in a hypothetical effect compartment (Emax model). The estimated half-life of the equilibration between plasma and effect site was about 2.34 hours. Monte Carlo simulation showed that the time when at least 50% of the patients have a 75% probability of achieving meaningful pain relief (pain intensity difference (PID > or = 1) for PBCD and Feldene at a dose of 20 mg was about 0.5 and 1.5 hours, respectively. PBCD demonstrated an advantage with an onset of pain relief 1 hour earlier than Feldene.
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PMID:Comparative population pharmacokinetic-pharmacodynamic analysis for piroxicam-beta-cyclodextrin and piroxicam. 1107 11

In attempts to avoid the systemic side effects of piroxicam (PC) (e.g. gastrotoxicity), several buccal gel formulations containing PC were prepared and their effects on the characteristics of the drug permeation through rabbit buccal mucosa in-vitro were evaluated using a Franz-type diffusion cell. The general rank order of the total flux of 0.5% PC from gels was found to be: hydroxypropylmethylcellulose (HPMC, 2.5%) > hydroxypropylcellulose (HPC, 2.5%) >or= sodium alginate (Na alg., 7%) > methylcellulose (MC, 3%) > hydroxyethylcellulose (HEC, 1.5%) > carbopol 934 (Carb. 934, 1%) >or= sodium carboxymethylcellulose (NaCMC, 2%) > pluronic F-127 (PF-127, 20%) > polyvinyl alcohol (PVA, 10%). The effect of various penetration enhancers 1% sodium lauryl sulphate (NaLS), 3% sodium deoxycholate (NaDC), 3% sodium tauroglycocholate (NaTGC) on the rate of permeation across the excised buccal mucosa (of 0.5% PC in gels prepared using 3% MC, 2.5% HPMC or 7% Na alg. base) and histology of the buccal epithelium was also investigated. Pharmacodynamic evaluation of the anti-inflammatory activity of PC in these gel formulations (containing 3% NaDC as an enhancer) was carried out using the kaolin-induced rat paw oedema method. The results obtained indicated that PC administered in 7% Na alg. or 2.5% HPMC gel bases was significantly more effective than the 3% MC gel and oral drug solution in suppressing oedema formation in rats. Comparative clinical studies were conducted in patients with post-operative dental pain and oedema following maxillofacial operations. The results revealed that 7% Na alg. and 2.5% HPMC gel formulations applied to the buccal mucosa were slightly better than or equally effective to the orally administered commercial product (Feldene Flash) tablet) in reducing pain level, swelling and tenderness within a period of 4 days. These findings suggest that PC (0.5%) administered in the buccal gel may present a potential therapeutical use as a strong anti-inflammatory and analgesic agent.
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PMID:Transbuccal permeation, anti-inflammatory activity and clinical efficacy of piroxicam formulated in different gels. 1511 10

There is considerable interest in developing new non-steroidal anti-inflammatory drugs (NSAIDs) formulations with faster onset of analgesic action like fast dissolving tablets. An open-label, randomized, single dose, crossover study with a 18 days washout period was conducted in 16 healthy volunteers to compare the pharmacokinetic profile of 20 mg piroxicam freeze-dried tablet (Proxalyoc, Cephalon) with that of 20 mg piroxicam capsule (Feldene, Pfizer). T(lag) with freeze-dried tablet was three times shorter than with capsule (21.6 min versus 59.4 min). Mean AUC(0-30 min), mean AUC(0-1 h), mean plasma concentrations at 15 min, 30 min and 1 h post-dose were significantly higher with the freeze-dried tablet than with the capsule, indicating that piroxicam was more rapidly absorbed from the freeze-dried tablet with higher plasma concentrations achieved at shorter intervals after dosing. The 90% confidence intervals of the ratios of means C(max), AUC(0-t), AUC(0-infinity) and T(1/2) all fell within the acceptance range of 0.8-1.25, demonstrating the bioequivalence of the two formulations. Although the bioavailability of the two formulations was similar, the administration of piroxicam as a freeze-dried tablet gave a much faster absorption rate during the first hour after dosing than the capsule formulation. This faster absorption is an obvious advantage for the treatment of acute episodes of pain.
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PMID:Pharmacokinetic profiles of two tablet formulations of piroxicam. 1584 98


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