Humans ; Anti-Inflammatory Agents, Non-Steroidal/adverse effects* ; Aspirin/therapeutic use* ; Respiration Disorders ; Respiratory Tract Diseases

OBJECTIVETo observe the rate of efficacy and adverse drug reaction of non-steroidal anti-inflammatory drugs (NSAIDs) in the population with osteoarthritis and rheumatoid arthritis, based on available clinical data.

METHODSUsing Meta analysis to evaluate the data of effect and safety profile of NSAIDs from 19 articles on randomized clinical trials published from 1990 to 2001 in Chinese journals. The total number of patients enrolled for evaluation on rates of effectiveness and adverse drug reaction were 1 732 and 2 925, respectively.

RESULTSData on the effect and safety were comparatively heterogeneous among different kinds of NSAIDs. The effective rates (95% CI) were as follows: nabunetone, 66.7% (61.9% - 71.4%); meloxicam, 68.4% (59.2% - 77.6%); naproxen, 64.5% (59.8% - 69.1%); nimesulide, 79.8% (75.7% - 84.0%); ibuprofen, 77.2% (70.7% - 83.8%); diclofenac, 77.1% (69.2% - 85.0%); oxaprozin, 65.8% (59.5% - 72.0%). Rates of adverse drug reaction (95% CI) were as follows: nabunetone, 16.3% (12.5% - 20.0%); meloxicam, 10.2% (4.2% - 16.2%); naproxen, 29.2% (24.8% - 33.6%); nimesulide, 20.2% (16.0% - 24.3%); ibuprofen, 16.7% (14.7% - 18.8%); diclofenac, 19.3% (11.9% - 26.7%); oxaprozin, 12.7% (8.9% - 16.7%) respectively.

CONCLUSIONThe rates of effect and adverse reaction on patients having osteoarthritis and rheumatoid arthritis with NSAIDs treatment would largely depend on the drugs being used. Within 2 - 8 weeks of treatment, the effective rate and rate of adverse drug reaction with commonly used NSAIDs as nabumeton, meloxicam, etc., were 59.2% - 85.0% and 4.2% - 33.6%, respectively.

Anti-Inflammatory Agents, Non-Steroidal ; adverse effects ; therapeutic use ; Arthritis, Rheumatoid ; drug therapy ; Butanones ; adverse effects ; therapeutic use ; China ; Diclofenac ; adverse effects ; therapeutic use ; Humans ; Ibuprofen ; adverse effects ; therapeutic use ; Naproxen ; adverse effects ; therapeutic use ; Osteoarthritis ; drug therapy ; Propionates ; adverse effects ; therapeutic use ; Randomized Controlled Trials as Topic ; Sulfonamides ; adverse effects ; therapeutic use ; Thiazines ; adverse effects ; therapeutic use ; Thiazoles ; adverse effects ; therapeutic use

The risk of lymphoproliferative disorders (LPDs) has been reported to be increased in autoimmune diseases and chronic inflammatory diseases. Similar with other chronic inflammatory diseases such as rheumatoid arthritis, there is a concern about the risk of LPDs in patients with inflammatory bowel disease (IBD). Generally, in IBD patients, the risk of LPDs appears to be similar with or very slightly higher, compared to the general population. The association of therapeutic agents with the risk of LPDs is difficult to evaluate due to multiple other potentially involved factors and co-treatment with other agents. To date, data show that thiopurine is associated with a moderately increased risk of LPDs in patients with IBD. Evidence regarding the risk of LPDs in IBD patients using methotrexate is not sufficient, but the risk of LPDs seems low. The responsibility of anti-TNF-alpha agents on the risk of LPDs is difficult to determine, because most of IBD patients receiving anti-TNF-alpha agents are co-treated with thiopurines. Attention should be given to the high risk of hepatosplenic T-cell lymphoma in young male patients treated with anti-TNF-alpha agents together with thiopurines. The risk and benefit of immunosuppressive therapy for IBD should be carefully evaluated and individualized considering the risk of LPDs.
Anti-Inflammatory Agents/therapeutic use ; Antibodies, Monoclonal/therapeutic use ; Azathioprine/adverse effects/therapeutic use ; Humans ; Immunosuppressive Agents/adverse effects/therapeutic use ; Inflammatory Bowel Diseases/complications/*drug therapy ; Lymphoproliferative Disorders/chemically induced/*etiology ; Methotrexate/therapeutic use ; Risk Factors

Anti-Inflammatory Agents ; adverse effects ; therapeutic use ; Colitis, Ulcerative ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Medicine, Chinese Traditional

Although a variety of regimens are available for the treatment of atopic dermatitis (AD), severe adverse reactions and unpopular costs often limit their usage. In contrast, certain inexpensive, naturally-occurring ingredients are proven effective for AD with fewer side effects. The beneficial effects of these ingredients can be attributed to inhibition of cytokine and chemokine expression, IgE production, inflammatory cell infiltration, histamine release, and/or the enhancement of epidermal permeability barrier function. Since herbal medicines are widely available, inexpensive and generally safe, they could be valuable alternatives for the treatment of AD, particularly for those patients who are not suitable for the utilization of immune modulators. In this review, we summarize the therapeutic benefits of natural ingredients for the treatment of AD and the mechanisms of their actions.
Anti-Inflammatory Agents ; pharmacology ; therapeutic use ; Biological Products ; adverse effects ; therapeutic use ; Dermatitis, Atopic ; drug therapy ; Humans ; Permeability ; Treatment Outcome

OBJECTIVETo evaluate the clinical efficiency of selective cyclo-oxygenase-2 (COX-2) inhibitor compared to traditional nonselective NSAIDs for the prevention of heterotopic ossification (HO) after total hip arthroplasty (THA).

METHODSBy searching Medline, Embase, CENTRAL (Cochrane Central Register of Controlled Trials) and Science Citation Index et al, only randomised controlled studies of selective COX-2 inhibitors VS nonselective COX-1 and COX-2 inhibitors for the prevention of HO after THA were included. The quality assessment of included studies was evaluated according to the standard of the Cochrane Collaboration, and the data were analysised by statistic software Stata 10.0. The HO incidence of both groups in different degrees was compared.

RESULTSFour eligible randomised controlled trials of totally 808 patients were included. Meta-analysis results showed that no statistically significant difference was found in overall incidence of HO (RR = 1.08, 95% CI: 0.71-1.64,P = 0.73), incidence of moderate severe HO (Brooker II and III) (RR = 0.83, 95% CI: 0.48-1.42, P = 0.49) and any grade of Brooker classification between two groups. In all included studies, 16 patients receiving nonselective COX inhibitor (4.4%) discontinued treatment because of gastrointestinal toxicity,whereas 10 patients in the selective COX-2 inhibitor group (2.7%) discontinued for gastrointestinal side effects.

CONCLUSIONThe selective COX-2 inhibitors are as equally effective as nonselective NSAIDs for the prevention of HO after THA. Considering the side effects of nonselective NSAIDs, selective COX-2 inhibitors were recommend for the prevention of HO after THA.

Anti-Inflammatory Agents, Non-Steroidal ; adverse effects ; therapeutic use ; Arthroplasty, Replacement, Hip ; adverse effects ; Cyclooxygenase 2 Inhibitors ; adverse effects ; therapeutic use ; Cyclooxygenase Inhibitors ; adverse effects ; therapeutic use ; Humans ; Ossification, Heterotopic ; prevention & control ; Randomized Controlled Trials as Topic

OBJECTIVETo evaluate the effects of policosanol on serum lipid and heme oxygenase-1 (HO-1) in patients with hyperlipidemia.

METHODSThis randomized, open study included 72 patients with hyperlipidemia. The patients were randomly assigned to treatment group (policosanol, 20 mg/d, n = 36) or placebo group (placebo, two tablets/d, n = 36). The levels of serum lipids, hypersensitive C-reactive protein (hs-CRP), HO-1 were assessed before and after 16 weeks treatment. Drug-induced adverse effects and events were recorded during the observation period. The serum HO-1 was measured by ELISA.

RESULTS(1) After 16 weeks, all parameters remained unchanged in the placebo group; the level of TC decreased from (7.01 ± 1.03) mmol/L to (5.66 ± 0.83) mmol/L (-19.4%, P < 0.01), the level of LDL-C decreased from (4.78 ± 0.72) mmol/L to (3.70 ± 0.69) mmol/L (-22.5%, P < 0.01) in the treatment group. TG and HDL-C levels remained unchanged (P > 0.05) while the level of HO-1 significantly decreased from (1.82 ± 1.08) µg/L to (1.45 ± 0.81) µg/L (P < 0.01) and the level of hs-CRP decreased from (3.40 ± 3.64) mg/L to (1.86 ± 2.02) mg/L (P < 0.01) in the treatment group. (2) Safety index was similar between placebo and treatment groups (P > 0.05) and there was no adverse events including allergic reaction, muscle pain in all subjects during the observation period.

CONCLUSIONThe short-term data obtained from this small hyperlipidemia patient cohort suggest that policosanol is a safe lipid-lowering and anti-inflammatory agent for hyperlipidemia patients.

Anti-Inflammatory Agents ; adverse effects ; therapeutic use ; Anticholesteremic Agents ; adverse effects ; therapeutic use ; Fatty Alcohols ; adverse effects ; therapeutic use ; Female ; Heme Oxygenase-1 ; metabolism ; Humans ; Hyperlipidemias ; blood ; drug therapy ; Lipids ; blood ; Male ; Middle Aged

MS14 is a natural herbal-marine drug, which has shown to slow down or halt the progression of multiple sclerosis (MS). This drug consists of 90% Penaeus latisculatus, 5% Apium graveolens, and 5% Hypericum perforatum L. Preclinically, the effects of MS14 have mostly been examined in an animal model of multiple sclerosis called experimental allergic encephalomyelitis (EAE). Clinical studies of the effects of MS14 in MS patients also showed that it could improve the patients' quality of life. MS14 is a safe drug in MS patients and might also be effective in the treatment of other neurodegenerative disorders with the same mechanisms.
Animals ; Anti-Inflammatory Agents ; therapeutic use ; Antioxidants ; therapeutic use ; Dose-Response Relationship, Drug ; Herbal Medicine ; Humans ; Iran ; Medicine, Traditional ; Mice ; Multiple Sclerosis ; drug therapy ; Plant Extracts ; adverse effects ; therapeutic use ; Seawater ; chemistry ; Tissue Extracts ; adverse effects ; therapeutic use

Analgesics, Opioid ; adverse effects ; therapeutic use ; Anti-Inflammatory Agents, Non-Steroidal ; therapeutic use ; Clinical Trials as Topic ; Disease Management ; Humans ; Pain, Intractable ; drug therapy ; physiopathology

OBJECTIVETo explore the therapeutic effects of Xiaozhong Zhitong mixture preventing heterotopic ossification (HO) after total hip arthroplasty.

METHODSFrom July 2006 to October 2009, 154 patients underwent total hip replacement surgery were randomly divided into sham group (group A, 50 cases), indomethacin group (group B, 55 cases) and Xiaozhong Zhitong mixture group (group C, 49 cases). Among 154 patients, 9 cases were primary osteoarthris, 34 cases osteoarthritis secondary to acetabular dysplasia, 98 cases osteoarthritis secondary to avascular necrosis of the femoral head, 2 cases rheumatoid arthritis, 5 cases femoral neck fracture, 6 cases other diseases. Modified Gibson approach was used during the operation. After operation, group A was no preventing treatment, group B was treated by indomethacin 50 mg every time, twice a day; group C was treated by Xiaozhong Zhitong mixture 50 ml every time, twice a day for 4 weeks. Eighteen months after operation was study termination point and X-ray (including the double hip anteroposterior,obturator oblique and iliac oblique film) was used to observe whether heterotopic ossification was formed (Brooker classification was used to evaluate ossification degree); Harris scoring was used to evaluate the function of hip joint,including PAHSS 80 scores and IAHSS 20 scores.

RESULTSAll the patients were followed up,with the average of duration of 21.2 months. The condition of heterotopic ossification: for group A,there were 27 cases with heterotopic ossification(54%) ,and Brooker I in 8 cases, II in 9 cases, III in 8 cases and IVin 2 cases; for group B, there were 12 cases heterotopic ossification (21.82%), and Brooker I in 10 cases, II in 2 cases; for group C, there were 11 cases heterotopic ossification(22.45%), and Brooker I in 9 cases, I in 2 cases. There was significant difference among three group in heterotopic ossification by rank test (P<0.05), but no difference between group B and C (P>0.05); there were no significant difference among three groups before treatment in Harris, PAHSS and IAHSS by analysis of variance (one-way ANOVA) (P>0.05), and has significant difference at 18 months after treatment (P<0.01). There were significant difference in Harris, PAHSS and IAHSS before and after treatment at 18 months (P<0.01). LSD-t was used to analyzed the scoring of Harris, PAHSS and IAHSS, there was significant difference among group A and group B and group C (P>0.05), but no difference between group B and C (P<0.01). There were gastrointestinal reaction in 5 of group A, 35 in group B and 4 in group C.

CONCLUSIONThe effect of Xiaozhong Zhitong mixture on the prevention of heterotopic ossification after total hip arthroplasty is similar to indomethacin, but Xiaozhong Zhitong mixture has the advantages of less side effects and easily acceptance by patients.

Aged ; Anti-Inflammatory Agents, Non-Steroidal ; therapeutic use ; Arthroplasty, Replacement, Hip ; adverse effects ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Ossification, Heterotopic ; prevention & control