scholarly journals A comparative study to assess the safety and efficacy of etoricoxib versus aceclofenac in osteoarthritis

2018 ◽  
Vol 7 (10) ◽  
pp. 2010
Author(s):  
Harsimrat S. Waraich ◽  
Vikas Kumar ◽  
Ashok Goel ◽  
Jatinder Singh
Keyword(s):  
Clinical Efficacy ◽  
Safety Profile ◽  
Signs And Symptoms ◽  
Severity Index ◽  
Degenerative Joint Disease ◽  
Joint Disease ◽  
Open Label ◽  
Intention To Treat ◽  
Safety Parameters ◽  
The Government

Background: Osteoarthritis (OA) is most common form of arthritis; also referred as degenerative joint disease or “wear and tear” arthritis. Cyclooxygenase-2 (COX-2) inhibitors are effective for pain and inflammation in OA and gained importance over conventional non-steroidal anti-inflammatory agents (NSAIDs), as causes significantly less toxicity, particularly, in gastrointestinal tract. The objective of the present research was to study the short-term comparative clinical efficacy of aceclofenac and etoricoxib in patients with osteoarthritis and to compare the safety profile of the two drugs i.e. aceclofenac and etoricoxib.Methods: The present study was a prospective, open label, parallel, intention to treat 80 patients out of 102 screened for osteoarthritis in the Department of Orthopaedics, Guru Nanak Dev Hospital attached to the Government Medical College, Amritsar. Patients were randomly divided in two groups with 40 patients each. Group A patients received Tab etoricoxib 60mg once daily and Group B patients received Tab. Aceclofenac 100mg twice daily. Patients were followed up after three weeks and at six weeks for clinical efficacy and safety.Results: Both the groups found to have significant improvement in signs and symptoms of osteoarthritis. However, aceclofenac was superior to etoricoxib in terms of change in visual analogue scale score, osteoarthritic severity index, patients’ and physicians’ global assessment while, etoricoxib was superior in terms of WOMAC osteoarthritic index and safety parameters in terms of ADR.Conclusions: Etoricoxib was better than conventional NSAIDs for the symptomatic management of osteoarthritis in terms of safety profile and clinical efficacy.

scholarly journals Clinical Efficacy and Safety Profile of Anterior Thalamic Stimulation for Intractable Epilepsy

2021 ◽  
Author(s):  
Michał Sobstyl ◽  
Angelika Stapińska-Syniec ◽  
Szczepan Iwański ◽  
Marcin Rylski
Keyword(s):  
Adverse Events ◽  
Clinical Efficacy ◽  
Safety Profile ◽  
Intractable Epilepsy ◽  
Brain Regions ◽  
Partial Seizures ◽  
Open Label ◽  
Double Blind ◽  
Stimulation Parameters ◽  
Number Of Patients

Abstract Introduction Deep brain stimulation of the anterior nucleus of the thalamus (ANT DBS) is a neuromodulation therapy for patients with refractory partial seizures. The ANT is the structure of a limbic system with abundant neuronal connections to temporal and frontal brain regions that participate in seizure propagation circuitry. State of the Art We have performed a literature search regarding the clinical efficacy of ANT DBS. We discuss the surgical technique of the implantation of DBS electrodes with special attention paid to the targeting methods of the ANT. Moreover, we present in detail the clinical efficacy of ANT DBS, with a special emphasis on the stimulation parameters, a stimulation mode, and polarity. We also report all adverse events and present the current limitations of ANT DBS. Clinical Implications In general, the safety profile of DBS in intractable epilepsy patients is good, with a low rate of surgery, hardware-related, and stimulation-induced adverse events. No significant cognitive declines or worsening of depressive symptoms was noted. At long-term follow-up, the quality-of-life scores have improved. The limitations of ANT DBS studies include a limited number of patients treated and mostly open-label designs with only one double-blind, randomized multicenter trial. Most studies do not report the etiology of intractable epilepsy or they include nonhomogeneous groups of patients affected by intractable epilepsy. There are no guidelines for setting initial stimulation parameters. All the variables mentioned may have a profound impact on the final outcome. Conclusions ANT DBS appears to be a safe and efficacious treatment, particularly in patients with refractory partial seizures (three-quarters of patients gained at least 50% seizure reduction after 5 years). ANT DBS reduces most effectively the seizures originating in the temporal and frontal lobes. The published results of ANT DBS highlight promise and hope for patients with intractable epilepsy.

scholarly journals Clinical and socio-demographic profile of treatment on osteoarthritis patients in Tirupathi, Andhra Pradesh, India

2017 ◽  
Vol 6 (8) ◽  
pp. 2010
Author(s):  
J. Viswanath ◽  
Chakrapani Cheekavolu ◽  
S. Sankaraiah ◽  
Renu Dixit
Keyword(s):  
Middle Class ◽  
Weight Bearing ◽  
Signs And Symptoms ◽  
Degenerative Joint Disease ◽  
Joint Disease ◽  
Mixed Diet ◽  
Medical College ◽  
Diet History ◽  
A Prospective Study ◽  
Middle Class Families

Background: Osteoarthritis is a chronic degenerative joint disease and it is slowly progressive with signs and symptoms being pain. It is a common cause of disability affecting 60-70% of the population in the age of 60 years. It usually affects the hand, large weight bearing joints, often the knee and the hip.Methods: A prospective study was carried out in S.V Ayurvedic Medical College and Hospital. Collected the data of Socio-demographic and risk factors (age, diet, history, marital status, religion, occupation etc.) during the treatment of osteoarthritis among the patients in hospital.Results: The data reveals that majority of the patients belongs to the age group of 51-60 (43.33%) and 41-50 years (33.33%) followed by 61-70years (16.66%), 31-40 years (6.66%), and 70 % of females, 30% patients were Males in present study. 90% were married 10% were widows. 63.33% of Hindu, 23.33 % were Muslims and only 13.33% were Christians. 40%, of labour, 33.33% Businessmen, 13.33% Servicemen and 13.33% House wives. 53.33% rural, 46.66% urban area. 50% were belonging to middle class while 23.33% were very poor status, 16.66% Rich only 10 % patients were from upper middle class families. 43.33% were Primary level education, 36.66% were illiterates, 10% up to Graduation, 6.66% Post-Graduation and 3.33% up to Matriculation. 63.33% mixed diet, 36.66% vegetarian.Conclusions: Present study reveals that, incidence of osteoarthritis was very high especially in elder female, married, Hindu, labour, rural area, middle class with very poor, primary education, mixed diet (vegetarian with non-vegetarian) patients. 

scholarly journals The Effect of TNF-α Inhibitors on Nail Psoriasis and Psoriatic Arthritis—Real-World Data from Dermatology Practice

2021 ◽  
Vol 11 (11) ◽  
pp. 1083
Author(s):  
Georgios Kokolakis ◽  
Robert Sabat ◽  
Imma Fischer ◽  
Susana Gomis-Kleindienst ◽  
Björn Fritz ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Severity Index ◽  
Observation Time ◽  
Joint Disease ◽  
Joint Involvement ◽  
Real World Data ◽  
Open Label ◽  
Term Care ◽  
Nail Psoriasis ◽  
Joint Symptoms

Patients with psoriatic arthritis (PsA) often develop joint symptoms years after their initial diagnosis of psoriasis disease; therefore, dermatologists should test for and detect PsA early. In this study, we focused on patients with psoriasis with both nail and joint disease being treated with tumor necrosis factor-α inhibitors by dermatologists. We performed a noninterventional, prospective, multicenter, and open-label study to evaluate the effectiveness of adalimumab, etanercept, or infliximab over 24 months of continuous therapy in patients with moderate to severe plaque-type psoriasis (Pso) and PsA. Disease assessments with the Psoriasis Area and Severity Index, Nail Psoriasis Severity Index (NAPSI), joint assessment, Dermatology Life Quality Index (DLQI), and Health Assessment Questionnaire (HAQ) instruments were performed every 3 months for the first year and twice annually thereafter. The cohort included 100 patients with Pso, nail psoriasis, and PsA. A significant reduction of NAPSI was observed 3 months after therapy initiation compared with the baseline (mean ± SD, 22.9 ± 17.8 vs. 33.8 ± 21.4; p < 0.001). Similarly, the mean ± SD number of both tender and swollen joints decreased significantly within the first 3 months of treatment, from 10.8 ± 11.5 to 6.4 ± 10.3 (p < 0.001) and from 6.4 ± 9.5 to 3.1 ± 7.2 (p < 0.001), respectively. Additionally, the distal interphalangeal joint involvement improved throughout the observation time, and DLQI and HAQ scores decreased. Improvements in control of skin, nail, and joint symptoms were seen, as well as in patients’ quality of life and functionality. Dermatologists have an important role not only in PsA diagnosis but also in PsA long-term care.

Psoriasis: IL-17A-Inhibitor zeigt gute Langzeitwirksamkeit

2020 ◽  
Vol 8 (1) ◽  
pp. 12-13
Author(s):  
Natalia Kirsten
Keyword(s):  
Safety Profile ◽  
Human Monoclonal Antibody ◽  
Life Quality ◽  
Severity Index ◽  
Severe Psoriasis ◽  
Open Label ◽  
The Core ◽  
Favourable Safety ◽  
Trial Treatment ◽  
Double Blinded

Background: Secukinumab, a fully human monoclonal antibody that selectively neutralizes IL-17A, has been shown to have significant efficacy and a favourable safety profile in the treatment of moderate-to-severe psoriasis and psoriatic arthritis. Objective: To assess the efficacy and safety of secukinumab through 5 years of treatment in moderate-to-severe psoriasis. Methods: In the core SCULPTURE study, Psoriasis Area and Severity Index (PASI) 75 responders at Week 12 continued receiving subcutaneous secukinumab until Year 1. Thereafter, patients entered the extension phase and continued treatment as per the core trial. Treatment was double-blinded until the end of Year 3 and open-label from Year 4. Here, we focus on the 300 mg fixed-interval (every 4 weeks) treatment, the recommended per label dose. Efficacy data are primarily reported as observed, but multiple imputation (MI) and last observation carried forward (LOCF) techniques were also undertaken as supportive analyses. Results: At Year 1, 168 patients entered the extension study and at the end of Year 5, 126 patients completed 300 mg (every 4 weeks) treatment. PASI 75/90/100 responses at Year 1 (88.9%, 68.5% and 43.8%, respectively) were sustained to Year 5 (88.5%, 66.4% and 41%). PASI responses were consistent regardless of the analysis undertaken (as observed, MI, or LOCF). The average improvement in mean PASI was approximately 90% through 5 years compared with core study baseline. DLQI (dermatology life quality index) 0/1 response also sustained through 5 years (72.7% at Year 1 and 65.5% at Year 5). The safety profile of secukinumab remained favourable, with no cumulative or unexpected safety concerns identified. Conclusion: Secukinumab 300 mg treatment delivered high and sustained levels of skin clearance and improved quality of life through 5 years in patients with moderate-to-severe psoriasis. Favourable safety established in the secukinumab phase 2/3 programme was maintained through 5 years.

Efalizumab for the Treatment of Psoriatic Arthritis

2007 ◽  
Vol 11 (2) ◽  
pp. 57-66 ◽  
Author(s):  
Kim A. Papp ◽  
Ivor Caro ◽  
Hoi M. Leung ◽  
Marvin Garovoy ◽  
Philip J. Mease
Keyword(s):  
Psoriatic Arthritis ◽  
Safety Profile ◽  
Treated Patient ◽  
Human Monoclonal Antibody ◽  
Joint Disease ◽  
Open Label ◽  
Double Blind ◽  
American College Of Rheumatology ◽  
Placebo Treated Patient ◽  
Background Therapy

Background: Psoriatic arthritis (PsA) is an inflammatory arthritis associated with psoriasis. Efalizumab, a T cell-targeted, recombinant human monoclonal antibody, is approved for the treatment of adult patients with chronic moderate to severe plaque psoriasis. The effect of efalizumab therapy on PsA has not previously been investigated. Objective: This phase II randomized, double-blind, placebo-controlled multicenter study evaluated the efficacy and safety of efalizumab for the treatment of PsA. Methods: Patients were required to be on at least one of the following concomitant systemic therapies for PsA: nonsteroidal anti-inflammatory drugs, corticosteroids, and/or sulfasalazine or methotrexate. One hundred fifteen patients with active PsA were enrolled and randomized in the study. Of these, 107 were treated weekly with efalizumab 1 mg/kg or placebo for 12 weeks, followed by 12 additional weeks of open-label efalizumab. Results: At week 12, 28% of efalizumab-treated patients achieved ACR-20 response (a 20% reduction from the baseline in the American College of Rheumatology response criteria), the primary end point, compared with 19% of placebo patients ( p = .27). The safety profile was comparable between efalizumab- and placebo-treated patient groups, regardless of methotrexate background therapy, and no worsening of joint disease occurred with efalizumab therapy. Conclusions: Efalizumab was not effective in treating PsA; efalizumab therapy did not worsen PsA. The efalizumab safety profile does not appear to be altered with the concomitant use of methotrexate therapy.

scholarly journals Pathogenesis of Degenerative Joint Disease in the Human Temporomandibular Joint

1995 ◽  
Vol 6 (3) ◽  
pp. 248-277 ◽  
Author(s):  
Christine L. Haskin ◽  
Stephen B. Milam ◽  
Ivan L. Cameron
Keyword(s):  
Temporomandibular Joint ◽  
Molecular Basis ◽  
Rational Design ◽  
Molecular Mechanisms ◽  
Signs And Symptoms ◽  
Degenerative Joint Disease ◽  
Arachidonic Acid Metabolism ◽  
Joint Disease ◽  
Molecular Features ◽  
Wide Range

The wide range of disease prevalences reported in epidemiological studies of temporomandibular degenerative joint disease reflects the fact that diagnoses are frequently guided by the presence or absence of non-specific signs and symptoms. Treatment is aimed at alleviating the disease symptoms rather than being guided by an understanding of the underlying disease processes. Much of our current understanding of disease processes in the temporomandibular joint is based on the study of other articular joints. Although it is likely that the molecular basis of pathogenesis is similar to that of other joints, additional study of the temporomandibular joint is required due to its unique structure and function. This review summarizes the unique structural and molecular features of the temporomandibular joint and the epidemiology of degenerative temporomandibular joint disease. As is discussed in this review, recent research has provided a better understanding of the molecular basis of degenerative joint disease processes, including insights into: the regulation of cytokine expression and activation, arachidonic acid metabolism, neural contributions to inflammation, mechanisms of extracellular matrix degradation, modulation of cell adhesion in inflammatory states, and the roles of free radicals and heat shock proteins in degenerative joint disease. Finally, the multiple cellular and molecular mechanisms involved in disease initiation and progression, along with factors that may modify the adaptive capacity of the joint, are presented as the basis for the rational design of new and more effective therapy.

Apportionment of Impairment from Meniscal Tears and Knee Arthritis

2013 ◽  
Vol 18 (5) ◽  
pp. 1-10 ◽  
Author(s):  
Charles N. Brooks ◽  
James B. Talmage
Keyword(s):  
Medial Meniscus ◽  
Degenerative Joint Disease ◽  
Joint Disease ◽  
Detailed Knowledge ◽  
Meniscal Tears ◽  
Knee Arthritis ◽  
Degenerative Arthritis ◽  
Study Results ◽  
Physical Findings ◽  
Causation Analysis

Abstract Meniscal tears and osteoarthritis (osteoarthrosis, degenerative arthritis, or degenerative joint disease) are two of the most common conditions involving the knee. This article includes definitions of apportionment and causes; presents a case report of initial and recurrent tears of the medial meniscus plus osteoarthritis (OA) in the medial compartment of the knee; and addresses questions regarding apportionment. The authors, experienced impairment raters who are knowledgeable regarding the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), show that, when instructions on impairment rating are incomplete, unclear, or inconsistent, interrater reliability diminishes (different physicians may derive different impairment estimates). Accurate apportionment of impairment is a demanding task that requires detailed knowledge of causation for the conditions in question; the mechanisms of injury or extent of exposures; prior and current symptoms, functional status, physical findings, and clinical study results; and use of the appropriate edition of the AMA Guides. Sometimes the available data are incomplete, requiring the rating physician to make assumptions. However, if those assumptions are reasonable and consistent with the medical literature and facts of the case, if the causation analysis is plausible, and if the examiner follows impairment rating instructions in the AMA Guides (or at least uses a rational and hence defensible method when instructions are suboptimal), the resulting apportionment should be credible.

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