scholarly journals STW1 and Its Versatile Pharmacological and Clinical Effects in Rheumatic Disorders: A Comprehensive Report

2020 ◽  
Vol 2020 ◽  
pp. 1-12
Author(s):  
Karl-Josef Gundermann ◽  
Jürgen Müller ◽  
Karin Kraft
Keyword(s):  
Rheumatic Diseases ◽  
Safety Profile ◽  
Comparable Efficacy ◽  
Inflammatory Rheumatic Diseases ◽  
Clinical Effects ◽  
Double Blind ◽  
Solidago Virgaurea ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
The Individual

Aim. To review the published and unpublished experimental and clinical studies about the efficacy and tolerability of STW1 and to compare the results to the efficacy and tolerability of investigated NSAIDs in parallel. Content. STW1 (Phytodolor®) contains a fixed combination of extracts from aspen leaves and bark (Populus tremula), common ash bark (Fraxinus excelsior), and goldenrod herb (Solidago virgaurea). It belongs to the group of anti-inflammatory and antirheumatic drugs, and it is authorized for the treatment of painful disorders of degenerative and inflammatory rheumatic diseases. The individual components have complementary effects. Its multifocal mode of action includes antiphlogistic, analgesic, antiexudative, antioxidative, antipyretic, and antiproliferative properties. The effects of both STW1 and its components have been verified in comprehensive pharmacological investigations. Open and randomized, placebo- and verum-controlled, and single-blind (sb) or double-blind (db) clinical trials, performed in different subtypes of rheumatic diseases confirm the pharmacological evidence. Its efficacy is comparable to a range of standard nonsteroidal anti-inflammatory drugs (NSAIDs) studied in parallel, but it has a superior safety profile. Conclusion. STW1 is a reasonable alternative to NSAIDs with comparable efficacy and a superior safety profile. It is also suitable to reduce the intake of NSAIDs.

scholarly journals The Safety of Medications During Pregnancy and Lactation in Patients with Inflammatory Rheumatic Diseases

2021 ◽  
Author(s):  
Ji-Won Kim ◽  
Chang-Hee Suh
Keyword(s):  
Rheumatic Diseases ◽  
Low Dose ◽  
Post Partum ◽  
Severe Disease ◽  
Inflammatory Rheumatic Diseases ◽  
Low Dose Aspirin ◽  
Pregnancy And Lactation ◽  
Inflammatory Drugs ◽  
Adverse Pregnancy ◽  
The Individual

The advances in treatments, including disease-modifying anti-rheumatic drugs and biologic agents, have significantly improved the management of inflammatory rheumatic diseases, allowing females with severe disease to become pregnant and lactate, previously considered as prohibited. Maintaining low disease activity with medications known to be safe from pre-conception to post-partum is a key point in reducing adverse pregnancy outcomes. Numerous observational and case studies have provided a growing amount of evidence on the use of safe anti-rheumatic medications in patients during pregnancy and lactation. Based on this information, this review discusses the safety of medications for patients with inflammatory rheumatic diseases during pregnancy and lactation. Among these, hydroxychloroquine, sulfasalazine, azathioprine, low-dose glucocorticoids, and low-dose aspirin are considered compatible with pregnancy, while methotrexate, cyclophosphamide, mycophenolate mofetil, and leflunomide are contraindicated. Non-steroidal anti-inflammatory drugs are only recommended for use early in pregnancy, as they are reported to cause rare but serious kidney problems in the fetus after 20 weeks or later. Cyclosporin, tacrolimus, and anti-TNF agents can be continued throughout pregnancy if the benefit is greater than the potential risk for the individual patient. Physicians should carefully weigh the risks and benefits of medications in patients with inflammatory rheumatic diseases considering pregnancy.

scholarly journals Cardiovascular safety of non-steroidal anti-inflammatory drugs in chronic inflammatory rheumatic diseases

2018 ◽  
Vol 90 (8) ◽  
pp. 101-106 ◽  
Author(s):  
B V Zavodovsky ◽  
L E Sivordova
Keyword(s):  
Side Effects ◽  
Rheumatic Diseases ◽  
Molecular Mechanisms ◽  
Inflammatory Rheumatic Diseases ◽  
Cardiovascular Safety ◽  
Cardiovascular Side Effects ◽  
Cardiovascular Morbidity And Mortality ◽  
Negative Effect ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

Rheumatic diseases (RD), such as rheumatoid arthritis, systemic lupus erythematosus, ankylosing spondylitis, psoriatic arthritis, vasculitis, gout are associated with increase in cardiovascular morbidity and mortality. The main causes of increased cardiovascular risk are inflammatory heart and vascular lesions, accelerated progression of atherosclerosis and side effects of drug therapy. Non-steroidal anti-inflammatory drugs (NSAIDs) are widely used in clinical practice and are on the list of the most prescribed medications. It is known that NSAIDs have a negative effect on the cardiovascular system (CVS). However NSAIDs may decrease the intensity of inflammation, which is an independent risk risk factor for CVS pathology. Therefore in patients with RD it is theoretically possible to reduce the severity of cardiovascular side effects when using NSAIDs. The article discusses the issues of NSAID’s cardiovascular safety, the molecular mechanisms underlying the negative effect of them on CVS, critically evaluated the results of main studies concerning the cardiovascular safety of NSAIDs in chronic inflammatory diseases.

scholarly journals Flavonoids: Nutraceuticals for Rheumatic Diseases via Targeting of Inflammasome Activation

2021 ◽  
Vol 22 (2) ◽  
pp. 488
Author(s):  
Young-Su Yi
Keyword(s):  
Rheumatic Diseases ◽  
Fruits And Vegetables ◽  
Inflammatory Responses ◽  
Protein Complexes ◽  
Cellular Damage ◽  
Inflammatory Rheumatic Diseases ◽  
Inflammasome Activation ◽  
Central Feature ◽  
Inflammatory Protein ◽  
Anti Inflammatory

Inflammation, an innate immune response that prevents cellular damage caused by pathogens, consists of two successive mechanisms, namely priming and triggering. While priming is an inflammation-preparation step, triggering is an inflammation-activation step, and the central feature of triggering is the activation of inflammasomes and intracellular inflammatory protein complexes. Flavonoids are natural phenolic compounds predominantly present in plants, fruits, and vegetables and are known to possess strong anti-inflammatory activities. The anti-inflammatory activity of flavonoids has long been demonstrated, with the main focus on the priming mechanisms, while increasing numbers of recent studies have redirected the research focus on the triggering step, and studies have reported that flavonoids inhibit inflammatory responses and diseases by targeting inflammasome activation. Rheumatic diseases are systemic inflammatory and autoimmune diseases that primarily affect joints and connective tissues, and they are associated with numerous deleterious effects. Here, we discuss the emerging literature on the ameliorative role of flavonoids targeting inflammasome activation in inflammatory rheumatic diseases.

scholarly journals Analysis of the use and adverse effects of non-steroidal anti-inflammatory drugs: A pilot study

2006 ◽  
Vol 63 (3) ◽  
pp. 271-277 ◽  
Author(s):  
Aneta Peric ◽  
Marija Toskic-Radojicic
Keyword(s):  
Pilot Study ◽  
Adverse Effects ◽  
Rheumatic Diseases ◽  
Test Results ◽  
Stomach Pain ◽  
Antiulcer Drugs ◽  
Inflammatory Drugs ◽  
The Mean ◽  
Anti Inflammatory ◽  
Number Of Males

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.

Action from the CRM: barbiturates

1980 ◽  
Vol 18 (3) ◽  
pp. 9-11
Keyword(s):  
Rheumatic Diseases ◽  
Efficacy And Safety ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

In 1975 the Committee on the Review of Medicines (CRM) began to examine the efficacy and safety of those drugs that were already on the market before 1971, when the present licensing procedures were introduced.1 It has already made recommendations on non-steroidal anti-inflammatory drugs2 and on other drugs used in rheumatic diseases,3 and these led to improvements in the data sheets for these products but had no obvious effects in practice. However, with its most recent recommendations on barbiturates, the CRM is showing its teeth.

Drug-drug interactions of non-steroidal anti-inflammatory drugs with other drugs in patients with rheumatic diseases

2005 ◽  
Vol 1 (2) ◽  
pp. 116-120 ◽  
Author(s):  
I. Peláez-Ballestasa ◽  
C. Meléndez-Mercado ◽  
A. Hernández-Garduño ◽  
J.L. Viramontes-Madrid ◽  
R. Burgos-Vargas
Keyword(s):  
Drug Interactions ◽  
Rheumatic Diseases ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

scholarly journals Differential effects of EPA and DHA on plasma and adipose tissue lipid mediators: the ComparED study

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Cécile Vors ◽  
Fabiana Piscitelli ◽  
Roberta Verde ◽  
Sofia Laforest ◽  
Janie Allaire ◽  
...  
Keyword(s):  
Adipose Tissue ◽  
Plasma Levels ◽  
Corn Oil ◽  
Lipid Mediators ◽  
High Dose ◽  
Low Grade ◽  
Double Blind ◽  
Epa And Dha ◽  
Anti Inflammatory ◽  
The Individual

AbstractOxylipins and endocannabinoids (eCBs) both belong to superclasses of lipid mediators with potent inflammation modulatory activities. The adipose tissue (AT) plays a key role in metabolic syndrome-related inflammation, via altered adipocyte physiology, infiltrated macrophages and altered profile of eCBs. We previously reported that DHA is more potent than EPA at modulating systemic inflammation, but the underlying mechanisms remain unclear. The objective of this study was to compare the individual effect of high-dose DHA and of EPA on circulating lipid mediators, i.e. plasma oxylipins and eCBs, and AT-related inflammation. In a randomized double-blind crossover trial, 154 volunteers with abdominal obesity and low-grade inflammation were subjected to three 10-wk supplementation phases: 1- EPA (2.7 g/d); 2- DHA (2.7 g/d); 3- corn oil (control), each separated by a 9-wk washout. Supplements were provided as re-esterified triacylglycerols. Profiling of plasma oxylipins and eCBs was performed on 58 subjects after each phase. Abdominal subcutaneous AT biopsies were also obtained from 13 individuals after each phase. Plasma DHA-, EPA-, arachidonic acid-derived oxylipins were analyzed by LC-MS. eCBs and some of their bioactive congeners were analyzed in plasma and AT by LC-APCI-MS. Adipocyte diameter was determined by histological analysis and AT macrophage infiltration was quantified by double immunofluorescence. Compared with EPA, DHA increased plasma levels of hydroxy-docosahexaenoic acids (7-, 11-, 14-, 4-, 17-HDOHE; P < 0.0001) and palmitoylethanolamide (PEA; P = 0.04). Compared with DHA, EPA led to higher plasma level of hydroxy-eicosapentaenoic acids (12-, 15-, 5-HEPE; P < 0.0001). In the AT, EPA increased the level of oleoylethanolamide (OEA; P = 0.01) compared with DHA, but no other difference was observed between treatments in adipose eCBs and eCB-related lipids. DHA and EPA did not differentially modify adipocyte size distributions (P > 0.50) and proportions of M1-type and M2-type macrophages (P > 0.30). In conclusion, increased plasma levels of anti-inflammatory DHA-derived oxylipins and plasma PEA may be responsible, at least to some extent, for the more potent anti-inflammatory effects of DHA compared with EPA observed in the ComparED study. Conversely, subcutaneous AT does not seem to be involved in explaining such differences between EPA and DHA.

Comparison of piroxicam and naproxen in osteoarthritis of the foot

1994 ◽  
Vol 84 (7) ◽  
pp. 348-354 ◽  
Author(s):  
MB Jennings
Keyword(s):  
Pain Relief ◽  
Joint Disease ◽  
Parallel Study ◽  
Double Blind ◽  
Significant Pain ◽  
The Us ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

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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