scholarly journals The Effects of Celecoxib or Naproxen on Blood Pressure in Pediatric Patients with Juvenile Idiopathic Arthritis

2015 ◽  
Vol 9 ◽  
pp. CMPed.S20720
Author(s):  
B. Falkner ◽  
M. Berger ◽  
P. Bhadra Brown ◽  
D. Iorga ◽  
R.W. Nickeson ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Juvenile Idiopathic Arthritis ◽  
Pediatric Patients ◽  
Treatment Options ◽  
Final Visit ◽  
Double Blind ◽  
Safety And Efficacy ◽  
Suitable Treatment ◽  
Inflammatory Drugs ◽  
Mean Differences

Background Selective and nonselective nonsteroidal anti-inflammatory drugs (NSAIDs) are indicated for the treatment of juvenile idiopathic arthritis (JIA). However, the effect of NSAIDs on blood pressure (BP) in children has not been rigorously examined. Methods In this randomized, double-blind, multicenter, active-controlled, 6-week trial, the safety and efficacy of celecoxib (50 mg twice daily [bid] or 100 mg bid) or naproxen (7.5 mg/kg bid) was evaluated in patients aged 2–17 years with JIA. Results The least squares (LS) mean difference (celecoxib – naproxen) in change from baseline to week 6/final visit in systolic BP was 1.10 (90% confidence interval, -0.56, 2.76). No significant LS mean differences in diastolic BP relative to baseline were reported. Treatment-emergent adverse events occurred in 48% of patients in each treatment group. Conclusion Both celecoxib and naproxen had no impact on BP, and both treatments had comparable safety profiles. Celecoxib, or naproxen, could be seen as suitable treatment options for pediatric patients with JIA.

scholarly journals Beyond the guidelines management of juvenile idiopathic arthritis: a case report of a girl with polyarticular disease refractory to multiple treatment options and Leri Weill syndrome

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Vana Vukić ◽  
Ana Smajo ◽  
Mandica Vidović ◽  
Rudolf Vukojević ◽  
Miroslav Harjaček ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Case Report ◽  
Treatment Options ◽  
Janus Kinase ◽  
Musculoskeletal Symptoms ◽  
Multiple Treatment ◽  
Number Of Patients ◽  
Systemic Glucocorticoids ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

Abstract Background The last two decades brought new treatment options and high quality guidelines into the paediatric rheumatologic practice. Nevertheless, a number of patients still present a diagnostic and therapeutic challenge due to combination of vague symptoms and unresponsiveness to available treatment modalities. Case presentation We report a case of sixteen years old girl suffering from polyarticular type of juvenile idiopathic arthritis refractory to multiple treatment options. She first presented at the age of 4 with swelling and contractures of both knees. Her symptoms were initially unresponsive to nonsteroidal anti-inflammatory drugs and progressed despite treatment with intraarticular and systemic glucocorticoids and methotrexate. Throughout the years, she received several biologics together with continuous administration of nonsteroidal anti-inflammatory drugs and disease modifying anti-rheumatic drugs as well as intraarticular and systemic glucocorticoids in disease flares. However, none of this options  provided a permanent remission, so various other modalities, as well as other possible diagnoses were constantly being considered. Eventually she became dependent on a daily dose of systemic glucocorticoids. In 2018, the treatment with Janus kinase inhibitor tofacitinib was initiated, which led to gradual amelioration of musculoskeletal symptoms, improvement of inflammatory markers and overall well-being, as well as to the weaning of systemic glucocorticoids. As the swelling of the wrists subsided for the first time in many years, Madelung’s deformity was noticed, first clinically, and later radiographically as well. Genetic analysis revealed short-stature homeobox gene deficiency and confirmed the diagnosis of Leri Weill syndrome. Conclusions This case report emphasizes the need for reporting refractory, complicated cases from everyday clinical practice in order to build-up the overall knowledge and share experience which is complementary to available guidelines. Individual reports of difficult to treat cases, especially when additional diagnoses are involved, can be helpful for physicians treating patients with common rheumatological diseases such as juvenile idiopathic arthritis.

A multicenter, double-blind, randomized safety and efficacy study of two dose levels of taliglucerase alfa in pediatric patients with Gaucher disease

2013 ◽  
Vol 108 (2) ◽  
pp. S101
Author(s):  
Ari Zimran ◽  
Derlis Emilio Gonzalez-Rodriguez ◽  
Aya Abrahamov ◽  
Deborah Elstein ◽  
Alona Paz ◽  
...  
Keyword(s):  
Gaucher Disease ◽  
Pediatric Patients ◽  
Efficacy Study ◽  
Double Blind ◽  
Safety And Efficacy ◽  
Dose Levels

scholarly journals A multicenter, randomized, double-blind placebo-controlled, single dose trial of the safety and efficacy of intravenous ibuprofen for treatment of pain in pediatric patients undergoing tonsillectomy

2014 ◽  
Vol 24 (5) ◽  
pp. 483-489 ◽  
Author(s):  
Jonathan R. Moss ◽  
Mehernoor F. Watcha ◽  
Laima P. Bendel ◽  
Denise L. McCarthy ◽  
Stacy L. Witham ◽  
...  
Keyword(s):  
Single Dose ◽  
Pediatric Patients ◽  
Double Blind ◽  
Safety And Efficacy ◽  
Double Blind Placebo ◽  
Dose Trial ◽  
Intravenous Ibuprofen

scholarly journals Safety and Efficacy of the ACE-Inhibitor Ramipril in Alport Syndrome: The Double-Blind, Randomized, Placebo-Controlled, Multicenter Phase III EARLY PRO-TECT Alport Trial in Pediatric Patients

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Oliver Gross ◽  
Tim Friede ◽  
Reinhard Hilgers ◽  
Anke Görlitz ◽  
Karsten Gavénis ◽  
...  
Keyword(s):  
Disease Progression ◽  
Alport Syndrome ◽  
Pediatric Patients ◽  
Ace Inhibitor ◽  
Adverse Drug Events ◽  
Phase Iii ◽  
Double Blind ◽  
Early Therapy ◽  
Safety And Efficacy ◽  
Multicenter Phase

Introduction. Retrospective observational data show that ACE-inhibitor therapy delays renal failure and improves life expectancy in Alport patients with proteinuria. The EARLY PRO-TECT Alport trial assesses the safety and efficacy of early therapy onset with ramipril in pediatric Alport patients. Methods and analysis. This double-blind, randomized, placebo-controlled, multicenter phase III trial (NCT01485978; EudraCT-number 2010-024300-10) includes 120 pediatric patients aged 24 months to 18 years with early stages of Alport syndrome (isolated hematuria or microalbuminuria). From March 2012, up to 80 patients will be randomized 1:1 to ramipril or placebo. In the event of disease progression during 3-year treatment, patients are unblinded and ramipril is initiated, if applicable. Approximately 40 patients receive open-label ramipril contributing to the safety database. Primary end-points are “time to progression to next disease level” and “incidence of adverse drug events before disease progression.” Treatment effect estimates from the randomized comparison and Alport registry data will be combined in supportive analyses to maximize evidence. Conclusion. Without this trial, ACE inhibitors may become standard off-label treatment in Alport syndrome without satisfactory evidence base. The results are expected to be of relevance for therapy of all pediatric patients with kidney disease, and the trial protocol might serve as a model for other rare pediatric glomerulopathies.

scholarly journals Assessment of safety and efficacy of oral nifedipine and intravenous labetalol in management of increased blood pressure in severe preeclampsia

2018 ◽  
Vol 7 (7) ◽  
pp. 2645 ◽  
Author(s):  
Sujana Thalamati ◽  
Sailaja Bandaru ◽  
Divyasree Bhumireddy
Keyword(s):  
Blood Pressure ◽  
Pregnant Women ◽  
Andhra Pradesh ◽  
Tertiary Care Hospital ◽  
Controlled Trial ◽  
Tertiary Care ◽  
Target Blood Pressure ◽  
Care Hospital ◽  
Double Blind ◽  
Safety And Efficacy

Background: Pre-eclampsia (PE) is a disorder of pregnancy characterized by the onset of high blood pressure and often a significant amount of protein in the urine. Pre-eclampsia is one of the leading causes of maternal and perinatal morbidity and mortality worldwide. The objective of the present study was to assess and compare the safety and efficacy of oral nifedipine and intravenous labetalol in the management of severe pre-eclampsia.Methods: A double-blind, randomized, controlled trial was conducted at a tertiary care hospital in Andhra Pradesh, on pregnant women presenting with a systolic blood pressure of 160 mm Hg or more or diastolic blood pressure of 110 mm Hg or more. The pregnant women were randomized to receive Oral nifedipine (10 mg tablet orally up to five doses) and intravenous labetalol injection in escalating doses until the target blood pressure of 150 mm Hg systolic and 100 mm Hg diastolic, or lower, was achieved. The primary endpoint of the study was the time taken by each agent to achieve target blood pressure. Secondary endpoints were number of doses required, adverse maternal and neonatal effects, side effect profile, and perinatal outcome.Results: The study was conducted in a tertiary care hospital in Andhra Pradesh from July 2016 to October 2017, on 100 pregnant women presenting with preeclampsia. The median time taken to achieve target blood pressure was 44 minutes (range: 20-60 minutes) for Oral Nifedipine and 68 minutes (range: 40-85 minutes) for Intravenous labetalol (P=0.008).  No serious adverse maternal or perinatal side effects were encountered in both the groups.Conclusions: Both oral nifedipine and intravenous labetalol are effective in the management of acute hypertensive emergencies of pregnancy; however, oral nifedipine effectively decreased the blood pressure rapidly compared to intravenous labetalol.

scholarly journals Comparison of Efficacy of Diclofenac and Paracetamol as Preemptive Analgesic Agent

2018 ◽  
Vol 11 (3) ◽  
pp. 1699-1706
Author(s):  
Vinishdharma Thenarasu ◽  
Deepa Gurunathan ◽  
M.P. Santhosh Kumar
Keyword(s):  
Analgesic Effect ◽  
Treatment Options ◽  
Preemptive Analgesia ◽  
Double Blind ◽  
Over The Counter ◽  
Dental Procedures ◽  
Double Blind Clinical Trial ◽  
Group A ◽  
Inflammatory Drugs ◽  
Group B

Extraction of teeth has been a common, routine dental procedure done in clinics which may lead to moderate to severe pain postoperatively. Any pain postoperatively may cause a discomfort in particpants and affects their routine lifestyle. Preemptive analgesics plays an important role in reducing postoperative pain and distress associated with painful dental procedures. Nonsteroidal anti-inflammatory drugs are one of the treatment options to be used as pain relief for surgical teeth extraction. Wherelse, another commonly prescribed drug over-the-counter is Paracetamol. The purpose of this study is to evaluate the analgesic effect of both the drug as an preemptive analgesia. This study is a double blind , clinical trial. Twenty particpants were randomised into two group. Group A receiving Paracetamol (500mg) and Group B receiving Diclofenac (100mg) orally, 30 minute before the extraction is done. The pain intensity and the duration of the analgesia is evaluated using the Visual Analog Scale (VAS). Patient who were given Diclofenac (100mg) show a higher analgesic effect compare to Paracetamol (500mg).However, the analgesic effect in patient received Diclofenac is much more longer then patient received Paracetemol. Two different drug has been used in this study to evaluate their efficacy as an preemptive analgesic and it can be concluded that Diclofenac is more effective then Paracetamol as an preemptive analgesia.

Comparative Antihypertensive Effects of Guanabenz and Clonidine

1982 ◽  
Vol 10 (1) ◽  
pp. 6-14 ◽  
Author(s):  
Barry R Walker ◽  
Larry E Hare ◽  
Marc W Deitch
Keyword(s):  
Blood Pressure ◽  
Adverse Effects ◽  
Diastolic Blood Pressure ◽  
Single Daily Dose ◽  
Double Blind Trial ◽  
Double Blind ◽  
Hypertensive Patients ◽  
Safety And Efficacy ◽  
Daily Dose ◽  
Clinically Significant

The safety and efficacy of guanabenz and clonidine were compared in 188 hypertensive patients during a 6-month double-blind trial. Mean supine diastolic blood pressure (SDBP) decreased from 103 to 88 mm Hg (p < 0.01) among guanabenz patients and from 101 to 88 mm Hg (p < 0.01) among clonidine patients who completed 6 months of b.i.d. therapy. Clinically significant individual SDBP decreases occurred in 85% of the guanabenz patients and in 83% of the clonidine patients after 6 months. Adverse effects, consisting primarily of drowsiness, dry mouth, dizziness, and weakness, were similar in the two therapy groups. The responses obtained with guanabenz (b.i.d.) were maintained, along with a decrease in adverse effects, by an equivalent single daily dose of guanabenz during a second 6 months of therapy. Seventy-six per cent (13/17) of the patients whose blood pressure was not adequately controlled by guanabenz alone after 8 weeks of therapy subsequently responded to a combination of guanabenz and hydrochlorothiazide. Similarly, 85% (17/20) of the patients who failed to respond to clonidine alone subsequently responded to guanabenz either alone or in combination with hydrochlorothiazide. These results suggest that guanabenz or the combination of guanabenz and hydrochlorothiazide is effective therapy for the majority of hypertensive patients.

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