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)

This 10-week, double-blind, crossover study compared piroxicam (20 mg administered once daily) and indomethacin (25 mg administered three times daily) in patients with rheumatoid arthritis. In the 30 patients evaluated, both drugs produced statistically significant improvement after 4 weeks compared to placebo in all parameters measured with the exception of joint swelling and 10 m walking time. Piroxicam provided greater improvement with respect to the severity of pain, joint tenderness and restoration of motion, and was significantly more effective than indomethacin in reducing the consumption of paracetamol and in improving morning stiffness. Both drugs were equally effective in improving the remaining parameters measured. Roughly, two-thirds of the patients considered piroxicam to be the more effective agent. With both drugs side effects were mild and infrequent.
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PMID:Double-blind crossover comparison of piroxicam and indomethacin in rheumatoid arthritis. 638 Aug 99

Piroxicam is a chemically different non-steroidal anti-inflammatory drug with a long half-life which enables it to be administered once daily. This member of the oxicam series of compounds is now well established in the treatment of rheumatoid arthritis and osteoarthritis and has been shown to be a suitable alternative to aspirin, indomethacin, naproxen, ibuprofen, ketoprofen, sulindac, phenylbutazone and diclofenac in the treatment of rheumatic diseases. Open trials in many thousands of patients in hospital clinics and in general practice have demonstrated its analgesic and anti-inflammatory efficacy in a wide cross-section of patients with rheumatic diseases, when administered once daily either at night or in the morning, and recent studies have demonstrated its usefulness in musculoskeletal disorders, dysmenorrhoea and postoperative pain. Such studies have also demonstrated the generally good tolerability of piroxicam 20mg daily. As with other non-steroidal anti-inflammatory drugs, gastrointestinal complaints are the most frequently reported side effects. The frequency and severity of these effects are dose related. Thus, piroxicam is now well established in the treatment of rheumatic diseases and offers an alternative to other analgesics in various pain states.
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PMID:Piroxicam. A reappraisal of its pharmacology and therapeutic efficacy. 638 26

Single doses of piroxicam (20 mg) and mefenamic acid (500 mg) were compared, double-blind, for analgesic effectiveness in the treatment of oral surgical pain in out-patients. Excluding placebo responders and patients with mild or no baseline pain, 118 cases (57 piroxicam, 61 mefenamic acid) were analyzed for efficacy. The treatments were statistically equivalent and highly effective; over 75% of patients in both groups reported a reduction of 2 points or more in pain severity. The percentage of patients reporting complete relief of severe pain was slightly higher for piroxicam, the onset of analgesic activity was equivalent, and side effects were infrequent (5%) and mild with both medications. Piroxicam was clearly efficacious in relieving post-exodontic pain. If these findings are confirmed in other painful conditions and safety on extended use is established, piroxicam should prove quite useful as a general analgesic for the treatment of a wide variety of painful conditions.
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PMID:Double-blind comparison of piroxicam and mefenamic acid in the treatment of oral surgical pain. 639 29

A double-blind study was conducted to compare the efficacy and safety of piroxicam with that of indomethacin in the treatment of inflammation associated with oral surgery. Patients received either 20 mg of piroxicam once daily or 25 mg of indomethacin three times daily for 5 days. Evaluations included assessments of pain and other indices of inflammation (swelling, redness and temperature). A trend favoring piroxicam over indomethacin in the effect on individual symptoms was noted at both Day 3 and Day 6. In the overall evaluations of improvement and drug usefulness at the end of the study, the better performance of piroxicam was statistically significant (p less than 0.05). The incidence of side effects was low for both drugs; indomethacin tended to produce slightly more headaches. Piroxicam should prove highly useful for the treatment of various types of inflammatory conditions, including that produced by oral surgery.
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PMID:Double-blind evaluation of piroxicam and indomethacin in the treatment of inflammation following oral surgery. 639 30

In a 14-day double-blind multicenter trial the efficacy and safety of piroxicam was compared with that of indomethacin among patients with extra-articular rheumatic conditions marked by cervicobrachial pain. The drugs were found to have comparable overall efficacy, with over 75% of the patients in both drug groups experiencing some improvement. Piroxicam appeared to provide somewhat better results in the subpopulation with cervicobrachial syndrome, while indomethacin was marginally better among patients with periarthritis scapulohumeralis. There was a trend toward better relief of nighttime pain with piroxicam in the cervicobrachial syndrome group at week 2. Fewer adverse reactions were observed with piroxicam, and the number of patients discontinued for side effects was also lower for piroxicam (4.1%) than for indomethacin (9.5%).
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PMID:Double-blind comparison of piroxicam and indomethacin in the treatment of cervicobrachial syndrome and periarthritis scapulohumeralis (stiff shoulder). 639 31

This 10-week, double-blind, crossover study compared piroxicam (20 mg given once daily) and indomethacin (25 mg given three times daily) in patients with rheumatoid arthritis. In the 30 patients evaluated, both drugs produced statistically significant improvement after 4 weeks compared to placebo in all measured parameters with the exception of joint swelling and 10 m walking time. Piroxicam tended to provide greater improvement in the severity of pain and joint tenderness than indomethacin, while both drugs were equally effective in improving morning stiffness, grip strength, and range of joint motion, and in decreasing paracetamol consumption. Nevertheless, roughly two-thirds of the patients considered piroxicam to be the more effective agent. With both drugs side effects were mild and infrequent.
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PMID:Double-blind crossover comparison of piroxicam and indomethacin in rheumatoid arthritis. 639 34

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 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

25 geriatric patients with normal renal function and ten patients with impaired renal function were treated with piroxicam (Felden) for osteoarthritis of the major joints. The objective was to determine the efficacy and toleration of the drug and, in particular, renal parameters and--in the case of the patients with renal insufficiency--the plasma levels of the drug. Piroxicam improved both pain and restricted movement in both groups and it caused only few side effects. The specific laboratory values did not change in the patients with normal renal function, while renal parameters sometimes even improved in the patients with renal insufficiency during the treatment with piroxicam. Piroxicam did not accumulate in these patients despite the impaired renal function; the plasma levels corresponded to those found in patients with normal renal function.
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PMID:[Antirheumatic treatment in old age and its effect on kidney function]. 727 86

Piroxicam-beta-cyclodextrin is a complex of the established nonsteroidal antiinflammatory drug (NSAID) piroxicam and an inert cyclic macromolecule, beta-cyclodextrin. In clinical trials in patients with rheumatic diseases or pain arising from other conditions, it was as effective an analgesic as standard piroxicam, and showed a faster onset of action on the first day of treatment. In short term pharmacodynamic studies in healthy volunteers, piroxicam-beta-cyclodextrin was equivalent to or tended to show less gastrointestinal mucosal toxicity than standard piroxicam, as assessed by endoscopy and faecal blood loss. However, no data are available on its comparative gastrointestinal mucosal effects from long term clinical trials using similar measures. Preliminary findings from a clinical study suggest piroxicam-beta-cyclodextrin caused fewer gastroduodenal lesions than tenoxicam. As with other NSAIDs, the majority of adverse events associated with piroxicam-beta-cyclodextrin in clinical trials were gastrointestinal in origin, with epigastric pain, heartburn and nausea the most common. Thus, piroxicam-beta-cyclodextrin is an effective agent in patients with rheumatic diseases or other pain states. When rapid analgesia is required in the initial treatment of acute pain, the faster onset of action of piroxicam-beta-cyclodextrin may be an advantage over the parent compound; however, this is unlikely to be important during long term therapy. The results of further long term trials are awaited before firm conclusions can be reached regarding the gastrointestinal tolerability of piroxicam-beta-cyclodextrin compared with that of standard piroxicam and other NSAIDs.
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PMID:Piroxicam-beta-cyclodextrin. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic potential in rheumatic diseases and pain states. 753 98


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