scholarly journals Clinical Outcomes of Aspirin Interaction with Other Non-Steroidal Anti-Inflammatory Drugs: A Systematic Review

2018 ◽  
Vol 21 (1s) ◽  
pp. 48s-73s ◽  
Author(s):  
Zuhair Alqahtani ◽  
Fakhreddin Jamali
Keyword(s):  
Clinical Trials ◽  
Platelet Aggregation ◽  
Clinical Outcomes ◽  
Randomized Clinical Trials ◽  
Ex Vivo ◽  
Biologically Active ◽  
Cardioprotective Effect ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Aggregation Level

Purpose: Concomitant use of some non-Aspirin nonsteroidal anti-inflammatory drugs (NANSAIDs) reduces the extent of platelet aggregation of Aspirin (acetylsalicylic acid). This is while many observational studies and clinical trials suggest that Aspirin reduces cardiovascular (CV) risk attributed to the use of NANSAIDs. Thus, the therapeutic outcome of the interaction needs to be assessed. Methods: We searched various databases up to October 2017 for molecular interaction studies between the drugs and long-term clinical outcomes based on randomized clinical trials and epidemiological observations that reported the effect estimates of CV risks (OR, RR or HR; 95% CI) of the interacting drugs alone or in combinations. Comparisons were made between outcomes after Aspirin alone, NANSAIDs alone and Aspirin with naproxen, ibuprofen, celecoxib, meloxicam, diclofenac or rofecoxib. Results: In total, 32 eligible studies (20 molecular interactions studies and 12 observational trials) were found. Conflicting in vitro/in vivo/ex vivo platelet aggregation data were found for ibuprofen, naproxen and celecoxib. Nevertheless, for naproxen, the interaction at the aggregation level did not amount to a loss of cardioprotective effects of Aspirin. Similarly, for ibuprofen, the results overwhelmingly suggest no negative clinical CV outcomes following the combination therapy. Meloxicam and rofecoxib neither interacted with Aspirin at the level of platelet aggregation nor altered clinical outcomes. The clinical outcomes data for celecoxib and diclofenac are in conflict. Conclusion: Aspirin appears to maintain its cardioprotective effect in the presence of naproxen, ibuprofen, meloxicam and rofecoxib. The limited available data suggest that the effect of interaction at the platelet aggregation level may dissipate shortly, or the reduced platelet aggregation yielded by the interaction may be sufficient for cardioprotection; i.e., no need for near complete aggregation. In addition, cardioprotective effect of Aspirin, despite reduced platelet aggregation caused by NANSAIDs, may be through its involvement in other mechanisms such as the renin-angiotensin system and/or metabolism of arachidonic acid to biologically active compounds mediated by cytochrome P450. This article is open to POST-PUBLICATION REVIEW. Registered readers (see “For Readers”) may comment by clicking on ABSTRACT on the issue’s contents page.

scholarly journals Clinical pharmacological particular qualities of original ibuprofen different forms in treatment of diseases manifesting by pain

2021 ◽  
Vol 23 (2) ◽  
pp. 175-180
Author(s):  
Mikhail V. Pchelintsev ◽  
Keyword(s):  
Clinical Trials ◽  
Present Article ◽  
Randomized Clinical Trials ◽  
Analgesic Efficacy ◽  
Special Consideration ◽  
Nociceptive Pain ◽  
Efficacy And Safety ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

In the present article, the role of non-steroidal anti-inflammatory drugs in treatment of different diseases manifesting by nociceptive pain is viewed. Special consideration is given to Ibuprofen, which is very often used as a non-prescription analgesic and/or anti-pyretic agent. Using the examples of randomized clinical trials and meta-analyzes carried on their basis, a high comparative analgesic efficacy and safety of use of original ibuprofen, Nurofen®, in different pharmaceutical forms in particular in a form of rapidly absorbed tablets and in combination with paracetamol.

Preemptive use of oral nonsteroidal anti-inflammatory drugs for the relief of inflammatory events after surgical removal of lower third molars: A systematic review with meta-analysis of placebo-controlled randomized clinical trials

2020 ◽  
Vol 48 (3) ◽  
pp. 293-307 ◽  
Author(s):  
Edson Luiz Cetira Filho ◽  
Francisco Samuel Rodrigues Carvalho ◽  
Paulo Goberlânio de Barros Silva ◽  
Daniel Almeida Ferreira Barbosa ◽  
Karuza Maria Alves Pereira ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Surgical Removal ◽  
Third Molars ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

scholarly journals Clinical data mining reveals analgesic effects of lapatinib in cancer patients

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Shuo Zhou ◽  
Fang Zheng ◽  
Chang-Guo Zhan
Keyword(s):  
Data Mining ◽  
Clinical Trials ◽  
Cancer Patients ◽  
Clinical Data ◽  
Randomized Clinical Trials ◽  
Analgesic Effects ◽  
Clinical Data Mining ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Lapatinib Treatment

AbstractMicrosomal prostaglandin E2 synthase 1 (mPGES-1) is recognized as a promising target for a next generation of anti-inflammatory drugs that are not expected to have the side effects of currently available anti-inflammatory drugs. Lapatinib, an FDA-approved drug for cancer treatment, has recently been identified as an mPGES-1 inhibitor. But the efficacy of lapatinib as an analgesic remains to be evaluated. In the present clinical data mining (CDM) study, we have collected and analyzed all lapatinib-related clinical data retrieved from clinicaltrials.gov. Our CDM utilized a meta-analysis protocol, but the clinical data analyzed were not limited to the primary and secondary outcomes of clinical trials, unlike conventional meta-analyses. All the pain-related data were used to determine the numbers and odd ratios (ORs) of various forms of pain in cancer patients with lapatinib treatment. The ORs, 95% confidence intervals, and P values for the differences in pain were calculated and the heterogeneous data across the trials were evaluated. For all forms of pain analyzed, the patients received lapatinib treatment have a reduced occurrence (OR 0.79; CI 0.70–0.89; P = 0.0002 for the overall effect). According to our CDM results, available clinical data for 12,765 patients enrolled in 20 randomized clinical trials indicate that lapatinib therapy is associated with a significant reduction in various forms of pain, including musculoskeletal pain, bone pain, headache, arthralgia, and pain in extremity, in cancer patients. Our CDM results have demonstrated the significant analgesic effects of lapatinib, suggesting that lapatinib may be repurposed as a novel type of analgesic.

scholarly journals Anti-Inflammatory Drugs in Patients with Ischemic Heart Disease

2021 ◽  
Vol 10 (13) ◽  
pp. 2835
Author(s):  
Ana María Pello Lázaro ◽  
Luis M. Blanco-Colio ◽  
Juan Antonio Franco Peláez ◽  
José Tuñón
Keyword(s):  
Clinical Trials ◽  
Acetylsalicylic Acid ◽  
Cardiovascular Events ◽  
Randomized Clinical Trials ◽  
Renin Angiotensin System ◽  
Clinical Settings ◽  
Potential Candidate ◽  
Angiotensin System ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

Inflammation has long been known to play a role in atherogenesis and plaque complication, as well as in some drugs used in therapy for atherosclerotic disease, such as statins, acetylsalicylic acid, and modulators of the renin-angiotensin system, which also have anti-inflammatory effects. Furthermore, inflammatory biomarkers have been demonstrated to predict the incidence of cardiovascular events. In spite of this, and with the exception of acetylsalicylic acid, non-steroidal anti-inflammatory drugs are unable to decrease the incidence of cardiovascular events and may even be harmful to the cardiovascular system. In recent years, other anti-inflammatory drugs, such as canakinumab and colchicine, have shown an ability to reduce the incidence of cardiovascular events in secondary prevention. Colchicine could be a potential candidate for use in clinical practice given its safety and low price, although the results of temporary studies require confirmation in large randomized clinical trials. In this paper, we discuss the evidence linking inflammation with atherosclerosis and review the results from various clinical trials performed with anti-inflammatory drugs. We also discuss the potential use of these drugs in routine clinical settings.

The Efficacy of Anti-inflammatory Agents in the Prevention of Atrial Fibrillation Recurrences

2020 ◽  
Vol 28 (1) ◽  
pp. 137-151
Author(s):  
Homa Nomani ◽  
Sara Saei ◽  
Thomas P. Johnston ◽  
Amirhossein Sahebkar ◽  
Amir Hooshang Mohammadpour
Keyword(s):  
Atrial Fibrillation ◽  
Clinical Trials ◽  
Therapeutic Option ◽  
General Rule ◽  
Promising Candidate ◽  
Term Basis ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Meta Analyses ◽  
Af Recurrence

: Several studies have indicated an association between inflammation and the recurrence of Atrial Fibrillation (AF), especially after ablation, which is a therapeutic option leading to local inflammation. On the other hand, each AF can lead to another AF, as a general rule. Thus, preventing recurrences of AF is extremely important for patient outcomes. In this paper, we attempted to review the effect of medicinal agents with anti-inflammatory properties on the prevention of AF recurrence. There are several randomized controlled trials (RCTs) and meta-analyses on the prevention of AF recurrence using agents with anti-inflammatory properties, which include steroids, colchicine, statins, and n-3 fatty acids (n-3 FA). Clinical trials evaluating the efficacy of anti-inflammatory drugs in preventing the recurrence of AF led to inconsistent results for corticosteroids, statins and n-3 FAs. These results may be related to the fact that inflammation is not the only factor responsible for triggering recurrences of AF. For example, the presence of structural, mechanical and electrical remodeling could potentially be the most important factors that trigger recurrences of AF but these factors have not been addressed in most of the reported studies. Therefore, future clinical trials are needed to compare the efficacy of anti-inflammatory drugs in AF patients with, or without other factors. For colchicine, a potent anti-inflammatory drug, there are limited studies. However, all the studies investigating colchicine in the context of AF were consistent and promising, especially when colchicine was used on a short-term basis following ablation in patients with paroxysmal AF. Therefore, colchicine could be a promising candidate for further clinical studies involving recurrent AF.

scholarly journals Macrophage Activation and Cytokine Release Syndrome in COVID-19: Current Updates and Analysis of Repurposed and Investigational Anti-Cytokine Drugs

Drug Research ◽  
2021 ◽  
Author(s):  
Ashif Iqubal ◽  
Farazul Hoda ◽  
Abul Kalam Najmi ◽  
Syed Ehtaishamul Haque
Keyword(s):  
Immune Response ◽  
Clinical Trials ◽  
Macrophage Activation ◽  
Fatality Rate ◽  
Cytokine Storm ◽  
Cytokine Release ◽  
Cytokine Release Syndrome ◽  
Disease Condition ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

AbstractCoronavirus disease (COVID-19) emerged from Wuhan, has now become pandemic and the mortality rate is growing exponentially. Clinical complication and fatality rate is much higher for patients having co-morbid issues. Compromised immune response and hyper inflammation is hall mark of pathogenesis and major cause of mortality. Cytokine release syndrome (CRS) or cytokine storm is a term used to affiliate the situation of hyper inflammation and therefore use of anti-cytokine and anti-inflammatory drugs is used to take care of this situation. Looking into the clinical benefit of these anti-inflammatory drugs, many of them enter into clinical trials. However, understanding the immunopathology of COVID-19 is important otherwise, indiscriminate use of these drugs could be fetal as there exists a very fine line of difference between viral clearing cytokines and inflammatory cytokines. If any drug suppresses the viral clearing cytokines, it will worsen the situation and hence, the use of these drugs must be based on the clinical condition, viral load, co-existing disease condition and severity of the infection.

scholarly journals NUTRITION FOR CORRECTING METABOLISM DISORDERS OF THE JOINT-LIGAMENT SYSTEM IN PHYSICALLY ACTIVE PEOPLE

2019 ◽  
Vol 19 (1) ◽  
pp. 108-116
Author(s):  
O Tolmachyov ◽  
A Vekovtsev ◽  
V Vovchenko ◽  
A Bykov ◽  
V Poznyakovsky
Keyword(s):  
Nutritional Support ◽  
Pain Syndrome ◽  
Disease Recurrence ◽  
Biologically Active ◽  
Control Group ◽  
Movement Activity ◽  
Physically Active ◽  
Daily Movement ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

Aim. The article deals with developing and assessing the efficiency of a complex nutritional support program for the joint-ligament system in athletes and physically active people. Materials and methods. The clinical evidence of biologically active substance (BAS) efficiency and functional orientation was obtained from the representative group of people with knee-joint osteoarthrosis. The main group of participants received a BAS complex with synergistic properties in terms of metabolism correction during osteoarthrosis: BAS 1 – 2 pills, BAS 2 – 1 capsule (2 times per day, 12 weeks), and BAS 3 – 1 capsule (2 times per day, 8 weeks). Nonsteroidal anti-inflammatory drugs were also prescribed to participants from the main and control groups. We used the general and special methods for assessing the quality and functional properties of specialized products. Knee joints were studied by using the Lequesne index (scores) characterizing pain syndrome, maximal distance, and daily movement activity. The intensity of pain syndrome was assessed with the visual analog scale (VAS, in mm). Results. We provided a scientific justification for the qualitative and quantitative content of BAS recipes for complex nutritional support of the joint-ligament system: BAS 1 – chondroprotective orientation; BAS 2 – an optimal source of minerals and vitamins; BAS 3 – polyunsaturated fatty acids. The results obtained revealed that specialized products improve the movement activity of participants with osteoarthrosis and significantly decrease pain syndrome (36 %). Apart from a chondroprotective effect such nutrition provides an anti-inflammatory effect and allows decreasing the intake of Nonsteroidal anti-inflammatory drugs in the absence of side effects. We revealed an insignificant number of disease recurrence – 6.7% (in the control group – 36.5 %) and established the mechanisms of such an influence. Conclusion. The application of biologically active complexes could serve as a reliable means of preventing and treating the diseases of the joint-ligament system, providing physical performance, and preserving health in athletes and physically active people.

Anti-nociceptive and anti-inflammatory activity of synthesized novel benzoxazole derivatives

2021 ◽  
Vol 20 ◽  
Author(s):  
Mansi L. Patil ◽  
Swati S. Gaikwad ◽  
Naresh J. Gaikwad
Keyword(s):  
Cytotoxic Activity ◽  
Research Study ◽  
Ex Vivo ◽  
Immunological Response ◽  
Inflammatory Activity ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Inflammatory Effect

Introduction: Pain is an immunological response to any infection or inflammation and long term use of pain management therapy includes use of Nonsteroidal anti-inflammatory drugs which is associated with occurrence of toxicity as well as gastrointestinal bleeding. Therefore, the investigation of new analgesic and anti-inflammatory agents remains a major challenge. Aims: The objective of this research study is to undergo the pharmacological evaluation of newly synthesized benzoxazole derivatives. These novel derivatives were evaluated for anti-nociceptive, anti-inflammatory and cytotoxic activity using various in-vivo and ex-vivo methods. Methods: The study was carried out using swiss mice (adult male) weighing between 20gm to 30gm and were divided into groups containing (n=6) six animals in each group for treatment. The anti-nociceptive activity was performed by using 0.1ml of 0.6% v/v acetic acid as nociception inducer and evaluated by the diminished number of abdominal writhes. The anti-inflammatory activity was done using 0.1 ml of 2% w/v Carrageenan induced paw edema method was observed which was evaluated by calculating the percent maximum possible effect. Histopathological evaluation and cytotoxic activity of the compounds was carried out. Results: The results of this research study revealed that synthesized derivatives (a, b, c, d and e) showed promising anti-nociceptive and anti-inflammatory effect along significantly higher cytotoxic activity in MCF-7 cell lines. Conclusion: It can be concluded that synthesized derivatives (a, b, c, d and e) have potential anti-nociceptive and anti-inflammatory effect along with cytotoxic activity and certain modification in structure may result in potent activity.

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