scholarly journals POS0281 RUBUS IDAEUS LEAF EXTRACT IMPROVES SYMPTOMS IN KNEE OSTEOARTHRITIS PATIENTS: RESULTS FROM A DOUBLE BLIND RANDOMIZED CLINICAL STUDY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 365.1-366
Author(s):  
Y. Henrotin ◽  
R. Le Cozannet ◽  
P. Franca-Berthon ◽  
R. Truillet ◽  
M. Cohen Solal

Background:Osteoarthritis (OA) is the most common cause of disability in older adults. Currently, the aim of the patient management is to reduce symptoms and to improve quality of life using therapeutic modalities with no adverse effects (1). Unfortunately, the first line treatments of OA symptoms remain nonsteroidal anti-inflammatory drugs (NSAIDS) and paracetamol which if long-term administration are associated with severe adverse effects. Therefore, we need of save alternative to manage chronic OA symptoms. One candidate is Rubus idaeus (raspberry) leaf extract rich in flavonoids and phenols known to inhibit inflammatory responses.Objectives:The aim of this study was to investigate the effects of a 12-weeks intervention with an ethanolic extract from Rubus idaeus leaf on symptoms of knee OA.Methods:The study was a randomized, double-blind, placebo-controlled, monocentric trial of 198 subjects with femoro-tibial OA. Subjects were randomized equally to receive one daily treatment during 3 months either of 1 cap of Rubus idaeus leaf extract 400 mg, or 200 mg or placebo (maltodextrine). The main objective of this first exploratory study was to assess pain reduction over time. Pain was measured using different scales from the Western Ontario McMaster osteoarthritis index (WOMAC) to the knee pain VAS.Results:In the ITT population, Rubus idaeus leaf extract 400 mg and 200 mg after 12 weeks of treatment reduced pain measured by the VAS respectively of -10.93 (1.95) mm and -8.51 (1.92) mm compared to baseline, while placebo group had a -3.84 (1.89) mm reduction. The mean pain decrease induced by Rubus ideaus leaf extract was over – 7 mm which is clinically relevant, and reached clinically statistical difference compared to placebo with the highest dose (p=0.017; 95% CI, -13.11 to -1.07). Interestingly, subgroup analysis on the participants with a BMI>25, highlighted clinically relevant pain reduction for the 400 and 200 mg doses compared to baseline of respectively -13.36 (2.26) mm and -11.25 (2.14) mm (placebo = -0.37 (2.16) mm). The reduction was statistically different versus placebo for both doses (400 mg p<0.0001; 95% CI, (-19.95 to -6.04) and 200 mg p=0.0008; 95% CI, (-17.64 to -4.12). There was no effect on the WOMAC subscale of pain.Conclusion:Rubus idaeus leaf extract, even at the low dose of 200 mg, was effective to relieve pain at short-term in-patient with knee OA. As Rubus idaeus leaf extract is well tolerated, it could be an alternative to nonsteroidal anti-inflammatory drugs and paracetamol to relieve knee joint pain in OA patients.References:[1]Bannuru RR, Osani MC, Vaysbrot EE, Arden NK, Bennell K, Bierma-Zeinstra SMA, Kraus VB, Lohmander LS, Abbott JH, Bhandari M, Blanco FJ, Espinosa R, Haugen IK, Lin J, Mandl LA, Moilanen E, Nakamura N, Snyder-Mackler L, Trojian T, Underwood M, McAlindon TE. OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis. Osteoarthritis Cartilage. 2019 Nov;27(11):1578-1589.Disclosure of Interests:Yves Henrotin Speakers bureau: Expanscience, Nestlé, Tilman, Consultant of: Naturex SA, Artialis SA, Tilman SA, Seigakaku, Stemmatters, Expanscience, Romain Le Cozannet Employee of: Naturex SA, Pascale Franca-Berthon Employee of: Naturex SA, Romain Truillet Employee of: Atlanstat, Martine Cohen Solal: None declared

Materials ◽  
2021 ◽  
Vol 14 (11) ◽  
pp. 2715
Author(s):  
Rodica Ana Ungur ◽  
Viorela Mihaela Ciortea ◽  
Laszlo Irsay ◽  
Alina Deniza Ciubean ◽  
Bogdana Adriana Năsui ◽  
...  

The non-steroidal anti-inflammatory drugs (NSAIDs) are the most used drugs in knee OA (osteoarthritis) treatment. Despite their efficiency in pain and inflammation alleviation, NSAIDs accumulate in the environment as chemical pollutants and have numerous genetic, morphologic, and functional negative effects on plants and animals. Ultrasound (US) therapy can improve pain, inflammation, and function in knee OA, without impact on environment, and with supplementary metabolic beneficial effects on cartilage compared to NSAIDs. These features recommend US therapy as alternative for NSAIDs use in knee OA treatment.


2006 ◽  
Vol 63 (3) ◽  
pp. 271-277 ◽  
Author(s):  
Aneta Peric ◽  
Marija Toskic-Radojicic

Background/Aim. The use and adverse effects of nonsteroidal anti-inflammatory drugs (NSAIDs) in outpatients with rheumatic diseases has not yet been studied enough. The aim of this study was to evaluate the data about the efficacy and safety of NSAIDs obtained from the questionnaires submitted to the outpatients receiving these drugs. Methods. The patients who had been prescribed any of NSAIDs within the period from June to September, 2004 were included in the study. The answers obtained from the questionnaires were statistically analyzed by means of ?2-test. Results. At the time of the study, 150 patients had been prescribed ibuprofen or some other NSAID. Out of the total number of dispensed questionnaires (n = 150), only 45 (30%) were shown to be correctly filled-in. Their analysis showed that 64.4% of the patients had suffered from rheumatic diseases for more than five years, and had regularly used NSAIDs. The average age of these patients was about 70 years, and the number of females was double as high as that of the males. The most frequently used NSAIDs were diclofenac and ibuprofen (46.14%, and 23.24%, respectively). According to the answers given by the patients, the most often adverse reactions were gastric complaints such as nausea (11.1%), and stomach pain (8.9%). Due to this, the majority of the patients (64.4%) used some of the antiulcer drugs, most often ranitidine (31.1%). Conclusion. The results of this pilot study revealed that among the outpatients suffering from rheumatic diseases, the number of females was double as high as the number of males, that these patients were of the mean age of 70 years, and that their diseases lasted longer than five years. Gastric complains such as nausea and gastric pain of mild intensity were the most often adverse effects of NSAIDs reported by our patients. It could be the consequence of the predominant use of diclofenac and ibuprofen, NSAIDs with mild to moderate ulcerogenic potential, as well as the concomitant use of H2-receptor antagonists.


2016 ◽  
Vol 18 (2) ◽  
pp. 10
Author(s):  
Daniel Chavarría DDS, MSc, PhD ◽  
Amaury Pozos DDS, MSc, PhD

Tramadol is a well known central acting analgesic drug, used in a wide variety of treatments within health sciences; including dentistry. Due to its lack of anti-inflammatory action and some adverse effects related mainly to opioid receptors agonism, it is not use as a routine alternative; keeping mainly for patients allergic to non-steroideal anti-inflammatory drugs or as an adjuvant to manage severe odontogenic pain.  Since new available evidence supports the possible analgesic effect of this drug when is applied locally in different sites, recent reports have been done to explore the same effect in the orofacial region, especially to improve the local management of odontogenic pain. This new perspective article summarize some of the current efforts develop to explore the peripheral Tramadol in dentistry; “a new use for an old drug”. 


Endoscopy ◽  
1999 ◽  
Vol 31 (9) ◽  
pp. 761-767 ◽  
Author(s):  
Schneider ◽  
Benz ◽  
Beermann ◽  
Schiebeler ◽  
Riemann

2009 ◽  
Vol 81 (12) ◽  
pp. 4734-4741 ◽  
Author(s):  
So Young Um ◽  
Myeon Woo Chung ◽  
Kyu-Bong Kim ◽  
Seon Hwa Kim ◽  
Ji Seon Oh ◽  
...  

2021 ◽  
Vol 15 (6) ◽  
pp. 84-90
Author(s):  
A. E. Karateev ◽  
E. Yu. Polishchuk ◽  
E. S. Filatova ◽  
A. S. Potapova ◽  
V. A. Nesterenko ◽  
...  

Non-steroidal anti-inflammatory drugs (NSAIDs) are the primary means of managing chronic osteoarthritis (OA) pain. The choice of NSAIDs is based on an analysis of the risk of adverse reactions (ARs). Objective: to evaluate the efficacy and safety of long-term use of NSAIDs for pain control in patients with OA in real clinical practice.Patients and methods. To assess the results of long-term use of NSAIDs in OA, a 12-month observational non-interventional study was conducted. It included 611 patients with knee, hip and generalized OA, and nonspecific back pain associated with OA of the facet joints. All patients were prescribed aceclofenac (Aertal®) 200 mg/day. The patients' condition was assessed 2 weeks, 3, 6, 9 and 12 months after the start of therapy. The following parameters were determined: the intensity of pain during movement and the general health assessment (GA) according to the visual analogue scale (VAS, 10 cm); pain intensity according to the Likert verbal rating scale (VRS) (0–4); the number of patients with a pain reduction of ≥50% from baseline; patients' assessment of the result of therapy according to Likert VRS (1–5). The development of ARs was recorded at each visit.Results and discussion. By month 12, 46.8% of patients had dropped out of observation. In patients who continued the study, the average severity of pain according to the VAS at baseline, after 2 weeks, 3, 6, 9 and 12 months was: 6.5±1.2; 4.8±1.4; 3.2±1.4; 2.6±1.4; 2.2±1.1; 1.4±1.1 cm, respectively (significant differences compared to the baseline for all points – p<0.05). The same differences were obtained in GA assessment.Within the indicated time frame, the number of patients with moderate / severe pain (on the Likert scale) decreased from 77.8 to 24.9; 2.9; 2.3; 0.9 and 0%, respectively. The number of patients with a pain reduction of ≥50% from baseline was 12.0; 65.1; 81.0; 88.5 and 84.0%, respectively. A good or excellent assessment of treatment results after 2 weeks was given by 63.3% of patients, and after 12 months – by 95.6%. ARs were observed in about 30% of patients, mainly mild or moderate dyspepsia (in 11.1–23.3%) and arterial hypertension (in 7.1–10.9%). No serious ARs were registered.Conclusion. Aceclofenac is an effective and relatively safe drug for the long-term management of chronic pain in OA.


2019 ◽  
Author(s):  
Nuru Abdu ◽  
Samuel Teweldemedhin ◽  
Asmerom Mosazghi ◽  
Luwam Asfaha ◽  
Makda Teshale ◽  
...  

Abstract Introduction: Globally, non-steroidal anti-inflammatory drugs (NSAIDs) usage in the elderly with chronic pain has been reported as frequent. Though it is fundamental in maintaining their quality of life, the risk of polypharmacy, drug interactions and adverse effects is of paramount importance as the elderly usually require multiple medications for their co-morbidities. If prescriptions are not appropriately monitored and managed, they are likely to expose patients to serious drug interactions and potentially fatal adverse effects. Thus, the objective of the study was to assess the appropriateness of NSAIDs use and incidence of NSAIDs related potential interactions in elderly. Methods: A descriptive cross-sectional study was conducted among elderly out-patients (aged 60 and above) who visited three hospitals in Asmara between August 22 and September 29, 2018. The sampling design was two-stage random sampling and data was collected using a questionnaire, exit interview and by abstracting information from patients’ clinical cards. Descriptive and analytical statistics including chi-square test and logistic regression were employed using SPSS. Results: A total of 285 elderly respondents were enrolled in the study with similar male to female ratio. One in four of all respondents were chronic NSAIDs users, of which 74.6% were not prescribed prophylactic gastro-protective agents (GPAs). About 20% of the elderly were involved in polypharmacy and nearly all of the encountered potential NSAIDs related interactions (n=322) with prescribed drugs were moderate. Diabetes and hypertension were significantly associated with chronic NSAIDs use (OR=3, 95% CI: 1.54, 5.84; OR=9.99, 95% CI: 4.46, 22.38) and incidence of drug interactions (OR=3.95, 95%CI: 1.92, 8.13; OR=3.12, 95%CI: 1.81, 5.33) while diabetes and cardiac problem were significantly associated with incidence of polypharmacy (OR=4.33, 95% CI: 2.36, 7.96; OR=3.56, 95% CI: 1.05, 12.11). Conclusion: Though the overall reflection of prescription pattern of NSAIDs during the study period was almost satisfactory, gastro-protective agents were poorly prescribed as a prophylaxis.


2018 ◽  
Vol 132 (14) ◽  
pp. 1529-1543 ◽  
Author(s):  
Simona Ronchetti ◽  
Graziella Migliorati ◽  
Stefano Bruscoli ◽  
Carlo Riccardi

An established body of knowledge and clinical practice has argued in favor of the use of glucocorticoids in various chronic inflammatory and autoimmune diseases. However, the very well-known adverse effects associated with their treatment hampers continuation of therapy with glucocorticoids. Analyses of the molecular mechanisms underlying the actions of glucocorticoids have led to the discovery of several mediators that add complexity and diversity to the puzzling world of these hormones and anti-inflammatory drugs. Such mediators hold great promise as alternative pharmacologic tools to be used as anti-inflammatory drugs with the same properties as glucocorticoids, but avoiding their metabolic side effects. This review summarizes findings about the molecular targets and mediators of glucocorticoid function.


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