Treatment: NSAIDs

2016 ◽  
Author(s):  
Jonathan Chan ◽  
Nigil Haroon
Keyword(s):  
Symptom Control ◽  
Pharmacological Therapy ◽  
First Line ◽  
Safety Concerns ◽  
Randomized Controlled ◽  
Equivalent Effect ◽  
Inhibit Prostaglandin Synthesis ◽  
Inflammatory Drugs ◽  
Disease Modifying

Non-steroidal anti-inflammatory drugs (NSAIDs) constitute a diverse group of medications that inhibit prostaglandin synthesis. NSAIDs form the first-line pharmacological therapy in ankylosing spondylitis (AS). A number of randomized controlled trials (RCTs) support the efficacy of NSAIDs in reducing pain and improving patient function. Head-to-head comparisons have demonstrated equivalent effect of different NSAIDs in symptom control. The proposed disease-modifying potential of regular NSAID therapy is debatable and recent literature provides evidence to the contrary. Several safety concerns have been raised regarding long-term use of NSAIDs, especially an increase in cardiovascular risk. This chapter discusses the pharmacology, efficacy in treatment of AS, disease-modifying potential, and safety concerns of NSAIDs.

Synovitis, Acne, Pustulosis, Hyperostosis, and Osteitis Syndrome – A Pictorial Review

2019 ◽  
Vol 1 ◽  
pp. 41-46
Author(s):  
Moomal Haris ◽  
Harun Gupta
Keyword(s):  
Inflammatory Process ◽  
Clinical Presentation ◽  
Symptom Control ◽  
Clinical Syndrome ◽  
First Line ◽  
Pictorial Review ◽  
Inflammatory Arthropathy ◽  
Inflammatory Drugs ◽  
Long Term Prognosis

Synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) is an acronym which encompasses SAPHO. SAPHO is a distinct clinical syndrome which involves the musculoskeletal and dermatological systems. The clinical presentation can be variable, and therefore, patients may present to non-specialists who are not familiar with the disease. It is, therefore, important for the radiologist to be aware of the imaging manifestations of SAPHO; as often, it is them who are the first to propose the diagnosis. Imaging allows differentiation of SAPHO from other disease processes such as inflammatory arthropathy, infection, and malignancy which can share similar features and also to demonstrate potentially subclinical areas of disease involvement. Treatment is empirical and aimed at symptom control and modifying the inflammatory process. Nonsteroidal anti-inflammatory drugs are the first-line agents. The disease has a good long-term prognosis, despite the challenges in diagnosis and treatment.

scholarly journals Disease-Modifying Effects of Long-Term and Continuous Use of Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) in Spondyloarthritis

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Rebecca S. Y. Wong
Keyword(s):  
Pain Relief ◽  
Adverse Effects ◽  
Musculoskeletal System ◽  
First Line ◽  
Disease Research ◽  
Inflammatory Drugs ◽  
Disease Modifying ◽  
Anti Inflammatory ◽  
Continuous Use

Spondyloarthritis or spondyloarthropathy (SpA) is a group of related rheumatic disorders, which presents with axial and nonaxial features, affecting structures within the musculoskeletal system, as well as other bodily systems. Both pharmacological and nonpharmacological therapeutic options are available for SpA. For decades, nonsteroidal anti-inflammatory drugs (NSAIDs) have been used as the first-line drugs to treat the disease. Research has shown that other than pain relief, NSAIDs have disease-modifying effects in SpA. However, to achieve these effects, continuous and/or long-term NSAID use is usually required. This review will give an overview of SpA, discuss NSAIDs and their disease-modifying effects in SpA, and highlight some of the important adverse effects of long-term and continuous NSAID use, particularly those related to the gastrointestinal, renal, and cardiovascular systems.

scholarly journals Pharmacotherapy Options in Rheumatoid Arthritis

2013 ◽  
Vol 6 ◽  
pp. CMAMD.S5558 ◽  
Author(s):  
Pradeep Kumar ◽  
Snehashish Banik
Keyword(s):  
Rheumatoid Arthritis ◽  
Biologic Therapy ◽  
First Line ◽  
Disease Modifying Antirheumatic Drugs ◽  
Antirheumatic Drugs ◽  
Safety Issues ◽  
Disease Modifying ◽  
Disease Modifying Agents ◽  
Term Data

Drugs form the mainstay of therapy in rheumatoid arthritis (RA). Five main classes of drugs are currently used: analgesics, non-steroidal anti-inflammatories (NSAIDs), glucocorticoids, nonbiologic and biologic disease-modifying antirheumatic drugs. Current clinical practice guidelines recommend that clinicians start biologic agents if patients have suboptimal response or intolerant to one or two traditional disease modifying agents (DMARDs). Methotrexate, sulfasalazine, leflunomide and hydroxychloroquine are the commonly used DMARDs. Currently, anti-TNF is the commonly used first line biologic worldwide followed by abatacept and it is usually combined with MTX. There is some evidence that tocilizumab is the most effective biologic as a monotherapy agent. Rituximab is generally not used as a first line biologic therapy due to safety issues but still as effective as anti-TNF. The long term data for the newer oral small molecule biologics such as tofacitinib is not available and hence used only as a last resort.

scholarly journals “Ow, doc, it hurts”

2016 ◽  
Vol 85 (1) ◽  
pp. 14-16
Author(s):  
Brandon Chau ◽  
Robert Bobotsis
Keyword(s):  
Chronic Pain ◽  
Multidisciplinary Approach ◽  
Tricyclic Antidepressants ◽  
Long Term Results ◽  
First Line ◽  
Second Line Therapy ◽  
Line Therapy ◽  
Topical Lidocaine ◽  
Inflammatory Drugs

In a world where medical conditions are increasingly understood, chronic pain remains among the most difficult to diagnose and treat. Current first-line treatment of nonmalignant chronic pain include tricyclic antidepressants and physiotherapy, while topical lidocaine, nonsteroidal anti-inflammatory drugs and other antidepressants serve as appropriate second-line therapy. Opioids, though highly effective analgesics, remain medical options of last resort due to their highly addictive properties. Surgical implantation of nerve stimulators and/or spinal decompression may also be considered for treatment of chronic pain. As a parallel course of treatment, complementary and alternative medicine such as acupuncture may also be considered. Unfortunately, people with pain are among the least anticipated patients that doctors will see, and lack of both patience and expertise often result in cookie-cutter prescriptions and standardized healthcare that do not benefit individual patients. In the ever-evolving field of pain management, recent evidence has shown that a multidisciplinary approach, rather than traditional physician-based management, offers the best long-term results to patients.

Selected problems in the use of genetic engineering biological therapy in patients with rheumatoid arthritis

2021 ◽  
Vol 6 (4) ◽  
pp. 36-39
Author(s):  
K. Leonova
Keyword(s):  
Rheumatoid Arthritis ◽  
Biological Therapy ◽  
Pharmacological Therapy ◽  
Genetically Engineered ◽  
Biological Drugs ◽  
Inflammatory Drugs ◽  
The Moment ◽  
Attending Physician

Rheumatoid arthritis, like any chronic non-infectious disease, requires constant pharmacological therapy and monitoring of treatment. To relieve exacerbation, maintain long-term remission and improve the quality of life of patients, basic anti-inflammatory drugs are used, which have passed many years of testing for efficacy and safety and are available for patients. But there is a group of drugs that have appeared relatively recently - genetically engineered biological drugs. At the moment, their use is somewhat limited due to the presence of a number of problems. With the accumulation of data on the study of the safety of genetically engineered drugs in the treatment of rheumatoid arthritis, it will be possible to solve many practical issues that arise in the attending physician during the supervision of patients.

Reversible Renal Failure Associated with Ibuprofen: Case Report and Review of the Literature

1984 ◽  
Vol 18 (1) ◽  
pp. 27-33 ◽  
Author(s):  
Therese I. Poirier
Keyword(s):  
Renal Failure ◽  
Prostaglandin Synthesis ◽  
Predisposing Factors ◽  
Analgesic Nephropathy ◽  
Probable Case ◽  
Renal Deterioration ◽  
Inhibit Prostaglandin Synthesis ◽  
Risk Patients ◽  
Inflammatory Drugs

A report of a probable case of acute, reversible renal failure and hyperkalemia, after an increase in dose of ibuprofen, is presented. Other cases of renal dysfunction associated with various nonsteroidal anti-inflammatory drugs (NSAIDs) are reviewed. The ability of NSAIDs to inhibit prostaglandin synthesis may explain the various renal consequences. Possible predisposing factors to renal deterioration include the amount of drug consumed, presence of compromised renal blood flow, underlying renal insufficiency, nephrotoxic drug combinations, and high urinary prostaglandin excretion. Generally, the renal failure with NSAIDs is acute and reversible, though analgesic nephropathy with papillary necrosis and chronic renal failure are reported. Electrolytes, blood urea nitrogen, and serum creatinine levels need to be monitored in high-risk patients with predisposing factors and for chronic, long-term use of drugs that inhibit prostaglandin synthesis.

Clinical features, treatment and outcome of discospondylitis in cats

2021 ◽  
pp. 1098612X2110201
Author(s):  
Sergio A Gomes ◽  
Laurent S Garosi ◽  
Sebastien Behr ◽  
Cristina Toni ◽  
Joana Tabanez ◽  
...  
Keyword(s):  
Antibiotic Therapy ◽  
Clinical Signs ◽  
Serum Biochemistry ◽  
Neurological Dysfunction ◽  
First Line ◽  
Laboratory Findings ◽  
Outcome Information ◽  
Amoxicillin Clavulanic Acid ◽  
Inflammatory Drugs

Objectives There is a paucity of information on feline discospondylitis. This study aimed to describe the signalment, clinical and laboratory findings, aetiological agents, treatment and outcome in cats affected by discospondylitis. Methods This was a retrospective review of the medical records of cats diagnosed with discospondylitis at four referral institutions. Results A total of 17 cats were identified. Most were domestic shorthair cats (76.5%) and male (58.8%), with a median age of 9 years (range 0.9–14) and a median duration of clinical signs of 3 weeks (range 0.3–16). All cats presented with spinal hyperaesthesia; 3/17 had pyrexia. Neurological dysfunction was found in 64.7% of cats, which was indicative of a T3–L3 or L4–S2 spinal segment, associated nerve root or associated nerve neurolocalisation. Haematology, serum biochemistry and urinalysis revealed occasional inconsistent non-specific changes. All cats underwent urine culture; 9/17 cats also had a distinct tissue cultured. Positive bacterial cultures were obtained in two cats (11.8%) for Staphylococcus species (urine, blood and intradiscal fine-needle aspirate) and Escherichia coli (urine); both presented with multifocal discospondylitis. Treatment was non-surgical in all cats, with sustained antibiotic therapy for a median of 3 months (range 1–9). Analgesia provided included non-steroidal anti-inflammatory drugs, alone or in combination with gabapentin. Restricted exercise was advised for a minimum of 4 weeks. Outcome information available in 12 cats was excellent in terms of pain control and neurological function in 10 cats (83.3%) at the time of stopping antibiotics. Recurrence occurred in one case, which had received a single antibiotic for 6 weeks, and relapsed 4 months after presentation. One other case failed to improve and was euthanased during the course of hospitalisation. Conclusions and relevance Feline discospondylitis is uncommon and no obvious signalment predisposition was found in this study. Spinal hyperaesthesia was universally present, with neurological dysfunction also highly prevalent. Bacterial culture was unrewarding in most cases. Amoxicillin–clavulanic acid or cephalosporins are reasonable choices for first-line antibiotics. Prognosis was favourable, with no long-term evidence of recurrence in cats on sustained antibiotic therapy, for a mean duration of 3 months.

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