[Efficacy, tolerability and therapeutic benefit of etodolac (Lodine 200) in rheumatologic practice]

Ximoprofen in ankylosing spondylitis. A double blind placebo controlled dose ranging study

Ximoprofen is a new propionic NSAID which has previously demonstrated its efficacy at a daily dose of 30 mg. The aim of the study was to evaluate the efficacy of different daily dosages of Ximoprofen in patients with active ankylosing spondylitis. For 2 weeks 5 parallel groups were studied: placebo and Ximoprofen at 5, 10, 20 and 30 mg daily. Response to treatment was defined as an improvement in pain (VAS 100 mm) of at least 50% during the study. 285 out of the 332 screened patients were included. At the end of the study, the percentage of responders was higher in the Ximoprofen groups (54%, 41%, 53%, 56% in the 5, 10, 20 and 30 mg groups, respectively) than in the placebo group (21%). The clearest dose related effect of Ximoprofen observed occurred after one week of treatment. This study 1/confirms the efficacy of Ximoprofen at a 30 mg daily dosage, 2/shows the persistence of this efficacy at lower dosages, 3/suggests that ankylosing spondylitis is a sensitive and relevant human model to assess NSAIDs at an early stage of clinical evaluation.

Double-blind comparison of etodolac and diclofenac in patients with rheumatoid arthritis

The efficacy and tolerability of etodolac was compared to diclofenac in a multi-centre, double-blind, randomized parallel group study. Fifty-three patients with rheumatoid arthritis received etodolac (400 mg/day) and 55 patients received diclofenac (150 mg/day) for 12 weeks. Thirty-nine etodolac-treated patients and 44 diclofenac-treated patients completed the study. At the final evaluation, etodolac-treated patients showed significant (p < or = 0.05) improvement for all 4 primary assessments (patients' and physicians' global evaluations, number of tender or painful joints, and number of swollen joints) and 6 of 7 secondary assessments, while diclofenac-treated patients showed significant improvement for 3 primary assessments (patients' and physicians' global evaluations and number of tender joints) and 3 secondary assessments. In the physicians' global assessment, improvement at the final evaluation was indicated for 58% of the etodolac-treated patients and 47% of the diclofenac-treated patients. Both etodolac and diclofenac were well tolerated. As expected for non-steroidal anti-inflammatory drugs, gastrointestinal side-effects were the most common, occurring in 12 patients in each group. There were no significant differences between groups in the incidence of any study event. In conclusion, the results of this study indicate that etodolac is well tolerated and effective in the treatment of rheumatoid arthritis, comparable to diclofenac.

Etodolac. A reappraisal of its pharmacology and therapeutic use in rheumatic diseases and pain states

Etodolac is a nonsteroidal anti-inflammatory drug (NSAID) effective in the treatment of rheumatoid arthritis, osteoarthritis and ankylosing spondylitis, and in the alleviation of postoperative pain. Etodolac also provides relief of other types of pain, including that arising from gouty conditions and traumatic injury. In all indications, etodolac appears to be at least as effective as other NSAIDs. The incidence of clinical adverse effects other than abdominal pain and dyspepsia is similar to that observed with placebo, and etodolac has been associated with a low rate of gastrointestinal ulceration and other serious events. Data from preliminary animal studies have suggested that etodolac may provide more selective inhibition of prostaglandin synthesis at sites of inflammation than some other currently available NSAIDs. Thus, available evidence indicates that etodolac, with its low incidence of gastrointestinal events, is an effective and well tolerated alternative to other NSAIDs in the treatment of arthritic diseases and pain of various aetiologies and should be considered a first-line therapy.

Safety of ketoprofen in the elderly: a prospective study on 20,000 patients

Safety is a major concern in drug therapy in the elderly. NSAIDs are often used in the elderly and may induce side-effects. With a view to monitor the safety profile of ketoprofen, 19,880 patients greater than 60 years of age were enrolled in a large scale open study. They received a 200 mg sustained release tablet once-a-day for one month, in almost all cases for osteoarthritis. Patients mean age was 72.2 +/- 6.7 years. At the end of treatment, overall efficacy was rated as excellent or good in 70.7% of cases by patients and 74.2% by physicians. Tolerability was judged excellent: 60.8%; good: 24.0%; moderate: 8.7%; and poor: 5.1%. Side-effects related to ketoprofen occurred in 15.3% of patients and led to withdrawal in 4.5%. The most frequent side-effects were related to the G.I. tract (13.5% of total patients). Severe G.I. side-effects (ulcer, melena) occurred in 0.03%. Skin side-effects occurred in 0.7% and were always benign. No relationship was found between the incidence of side-effects and age or dosing time. In contrast, a higher incidence of side-effects was demonstrated in women, in case of associated disorders or concomitant therapy and in patients previously treated with other NSAIDs. In conclusion, in this very large population of elderly patients, ketoprofen had a good risk/benefit ratio.