Clinical efficacy of etocoxib combined with low dose colchicine in the treatment of acute gouty arthritis in 37 patients / 中国基层医药

Objective:To investigate the clinical efficacy of etocoxib combined with low-dose colchicine in the treatment of acute gouty arthritis in 37 patients.Methods:A total of 74 patients with acute gouty arthritis who received treatment in The Second People's Hospital of Liaocheng from October 2019 to October 2021 were included in this study. They were randomly assigned to undergo treatment with etocoxib alone (control group, n = 37) or etocoxib combined with low-dose colchicine (observation group, n = 37). All patients were treated for 1 week. Clinical efficacy, Visual Analogue Scale score, laboratory indicators, incidence of adverse reactions, and Quality of Life Comprehensive Assessment Questionnaire-74 score were compared between the two groups. Results:The total response rate in the observation group was significantly higher than that in the control group [95% (35/37) vs. 65% (24/37)]. At 1, 3, and 6 days after treatment, the Visual Analogue Scale score in the observation group was significantly lower than that in the control group ( t = 19.77, 15.43, 29.01, all P < 0.001). After treatment, blood uric acid, C-reactive protein, and erythrocyte sedimentation rate in the observation group was (432.26 ± 31.26) μmol/L, (16.25 ± 1.62) mg/L, (31.26 ± 1.25) mm/h, respectively, which was significantly lower than (485.26 ± 39.62) μmol/L, (45.26 ± 3.88) mg/L, (46.52 ± 2.82) mm/h in the control group ( t = 6.39, 41.97, 30.09, all P < 0.001). Quality of Life Comprehensive Assessment Questionnaire-74 score in the observation group was significantly higher than that in the control group ( t = 13.41, 17.73, 16.09, 11.77, all P < 0.001). There was no significant difference in the incidence of adverse reactions between the two groups ( P > 0.05). Conclusion:Etocoxib combined with low-dose colchicine can effectively reduce pain and inflammatory reactions in patients with acute gouty arthritis and improve quality of life, with a low incidence of adverse reactions.

Effects of etoricoxib and sodium hyaluronate on pain and inflammatory factors in patients with knee osteoarthritis / 中国医师进修杂志

Objective:To explore the effects of etoricoxib combined with sodium hyaluronate on pain and inflammatory factors in patients with knee osteoarthritis (KOA).Methods:A total of 106 KOA patients admitted to Zhujiang Hospital of Southern Medical University were selected as the research objects from March 2018 to October 2020, and they were divided into a control group and a study group using a random number table method, with 53 cases in each group. The control group was treated with sodium hyaluronate, and the study group was treated with etoricoxib on the basis of the control group. The effects of both groups were observed after continuous treatment for 4 weeks. The clinical efficacy and changes of knee joint function, pain and inflammatory factors before and after treatment were compared between the two groups, and the occurrence of adverse reactions during the treatment period was recorded.Results:The total effective rate of the study group was higher than that of the control group: 92.45%(49/53) vs. 77.36%(41/53), the difference was statistically significant ( P<0.05). The American Knee Association score (AKS) and Lysholm score after treatment in the two groups were higher than before treatment ( P<0.05), and the AKS score and Lysholm score in the study group after treatment were higher than control group: (171.84 ± 24.16) scores vs. (159.09 ± 22.21) scores, (81.62 ± 14.76) scores vs. (75.41 ± 13.58) scores, the difference was statistically significant ( P<0.05). The visual analogue score (VAS) of pain after treatment in the two groups was lower than before treatment, and the VAS score of the study group after treatment was lower than the control group: (3.01 ± 0.54) scores vs. (3.45 ± 0.64) scores. the difference was statistically significant ( P<0.05). The levels of interleukin-1β (IL-1β), matrix metalloproteinase-3 (MMP-3) and matrix metalloproteinase-9 (MMP-9) after treatment in the two groups were lower than before treatment, TIL-1β, MMP-3, and MMP-9 of the study group after treatment were lower than the control group: (56.38 ± 9.67) μg/L vs. (62.19 ± 10.73) μg/L, (91.56 ± 15.18) μg/L vs. (98.09 ± 16.74) μg/L, (30.46 ± 5.59) μg/L vs. (35.03 ± 6.27) μg/L, the difference was statistically significant ( P<0.05). There was no statistically significant difference in the incidence of total adverse reactions between the two groups ( P>0.05). Conclusions:Tocoxib combined with sodium hyaluronate in the treatment of KOA can improve the clinical efficacy, improve knee joint function, relieve pain, reduce the level of inflammatory factors, and have good safety.

Evaluating the efficacy of Etoricoxib in reducing post-operative pain associated with minor oral surgery. A randomized clinical trial / Avaliação da eficácia do Etoricoxibe na redução da dor pós-operatória associada à cirurgia oral menor: ensaio clínico randomizado

Etoricoxib, a new cyclooxygenase-2-selective inhibitor has demonstrated a rapid onset analgesic effect for relieving acute pain especially when prescribed as a pre-emptive medication. On these bases, this study may provide useful information and guidance for clinicians working in the field of oral surgery, as regards handling odontogenic pain and postoperative pain precisely with cyclooxygenase-2 inhibitors. Objective: the study aimed to measure the quantifiable efficacy of Etoricoxib in reducing post-extraction pain in subjects undergoing minor oral surgical intervention as compared to Naproxen (a traditional NSAID) which is commonly used to control postoperative pain. Material and Methods: a 120 mg film-coated tablet of Etoricoxib was given to each of the twenty patients representing the study group, and a 500 mg tablet of Naproxen was given to each of the other twenty subjects representing the positive control group. According to manufacturer instructions, the tablets were given to the subjects 30 minutes pre-operatively (before dental extraction). Post-operative pain was assessed for each subject using eleven points from zero to ten, visual analog scale. Results: showed no statistically significant difference between Etoricoxib and Naproxen in decreasing post-extraction odontogenic pain, suggesting that Etoricoxib is as efficient as Naproxen in the control of discomfort with dental origin taking into consideration the patient's status when prescribing the medication. Conclusion: this study suggests that Etoricoxib can be handled as a pre-emptive medication to reduce post-operative pain for subjects seeking traditional or surgical extraction of any of their teeth (AU)

O Etoricoxibe, um novo inibidor seletivo da ciclooxigenase-2, demonstrou um efeito analgésico de início rápido para aliviar a dor aguda, especialmente quando prescrito como medicação preventiva. Com base nesses fundamentos, este estudo pode fornecer informações úteis e orientação para clínicos que trabalham no campo da cirurgia oral, no que diz respeito ao manejo da dor odontogênica e da dor pós-operatória de forma precisa com inibidores da ciclooxigenase-2. Objetivo: o estudo teve como objetivo medir a eficácia quantificável do Etoricoxibe na redução da dor pós-extração em indivíduos submetidos a intervenção cirúrgica oral menor, comparado ao Naproxeno (AINE tradicional) que é comumente usado para controlar a dor pós-operatória. Material e Métodos: um comprimido revestido com um filme de 120 mg de Etoricoxibe foi administrado a cada um dos 20 pacientes representando o grupo de estudo, e um comprimido de 500 mg de Naproxeno foi administrado a cada um dos outros vinte sujeitos representando o grupo de controle positivo. De acordo com as instruções do fabricante, os comprimidos foram administrados aos indivíduos 30 minutos antes da cirurgia (antes da extração dentária). A dor pós-operatória foi avaliada para cada sujeito usando uma escala analógica visual de onze pontos, de zero a dez. Resultados: não mostraram diferença estatisticamente significativa entre o Etoricoxibe e o Naproxeno na diminuição da dor odontogênica pós-extração, sugerindo que o Etoricoxibe é tão eficiente quanto o Naproxeno no controle do desconforto de origem dentária, levando em consideração o estado do paciente ao prescrever a medicação. Conclusão: este estudo sugere que o Etoricoxibe pode ser administrado como medicação preventiva para reduzir a dor pós-operatória em indivíduos que buscam extração dentária tradicional ou cirúrgica de qualquer um de seus dentes. (AU)

Efficacy of Methylprednisolone and Etoricoxib Combination to attenuate Post-operative Pain and Nausea/Vomiting in Laparoscopic Surgeries

Background and Aims:Pain and PONV (postopera?ve nausea and vomi?ng) are common complaints in the period following surgery. A mul?modal approach targe?ng the reduc?on of postopera?ve pain with an opioid-sparing analgesic along with an an?eme?c medica?on would minimize opioid consump?on and its associated side effects. We evaluated the efficacy of methylprednisolone 125 mg IV taken along with oral 120 mg etoricoxib on postopera?ve pain and PONV in pa?ents undergoing laparoscopic surgeries Material and methods:A prospec?ve, randomized, double-blind study was conducted on 70 pa?ents aged between 18 and 60 years with ASA grade 1 and 2 posted for elec?ve laparoscopic surgeries. The test group was given a combina?on of methylprednisolone 125mgIV (given just before induc?on)& etoricoxib120mg oral (given 1 hr before surgery). (Group A, n=35) while control group received normal saline IV and a placebo per oral(Group B, n=35). Dura?on and quality of analgesia was assessed by visual analogue scale (VAS) score at 2,4,6,8,10,12,16,20 and 24hr as primary objec?ve. Total dose of rescue analgesic(injec?on Fentanyl 50 mcg) in first 24 hours, peri-opera?ve hemodynamic change and post op nausea vomi?ng (PONV) were observed as secondary objec?ve. Result:Demographic profiles were comparable. Dura?on of postopera?ve analgesia was significantly prolonged(p<0.05) in Group A(7.57±1.04hrs) as compared to Group B(3.05±0.5hrs). Group A showed a significant reduc?on in postopera?ve fentanyl consump?on in the form of rescue analgesic(p<0.05). Group A also showed significant reduc?on in the incidence of PONV(p<0.05). Conclusion:We conclude that single-dose administra?on of methylprednisolone IV along with oral etoricoxib has be?er analgesic efficacy in comparison to placebo for pa?ents undergoing laparoscopic surgeries.

A Randomized Double-Blind Comparative Study of Efficacy and Safety Between Low-Dose Etoricoxib and Ibuprofen Coadministered with Low-Dose Paracetamol for Dental Pain

Objective: To study the safety and efficacy of low-dose etoricoxib and low-dose paracetamol versus ibuprofen and low-dose paracetamol treatments in patients who experienced acute pain after tooth extraction. Methods: A total of 80 patients were recruited and randomized to two study groups, i.e., EP and IP. Group EP received etoricoxib 30 mg once a day and add-on paracetamol 325 mg eight-hourly, and Group IP received ibuprofen 400 mg and paracetamol 325 mg eight-hourly for three days. The analgesic efficacy was assessed by a visual analog scale, pain relief score, and global evaluation score. Patients were assessed at 0, 6, 24, 48, and 72 h. Safety was assessed by the patient’s estimation of the severity of adverse drug reactions using a 3-point scale and the type of adverse drug reactions reported by the patients after 72 h. Results: Mean pain intensity reduction, mean pain relief score, and global evaluation score all showed better analgesic efficacy results in Group EP as compared to Group IP but were not significant (P > 0.05) at 6, 24, 48, and 72 h, respectively. No patient had reported any serious adverse drug reaction in both the groups. Mild to moderate adverse reactions were reported in 20% cases in the IP group and 10% cases in the EP group; however, the incidence of GIT intolerance was seen in 17.5% of the cases in the IP group and none in the EP group. Conclusion: Low-dose etoricoxib with low-dose paracetamol has comparable analgesic efficacy with better safety than therapeutic dose ibuprofen and low-dose paracetamol.

The clinical effect of Yaotongning capsule combined with etoricoxib in the treatment of lumbar pain and inflammatory status in elderly patients with lumbar osteoarthritis / 药学实践杂志

Objective To study the clinical effect of Yaotongning capsule combined with etoricoxib for the pain and inflammation of lumbar vertebrae in elderly patients with lumbar osteoarthritis. Methods 120 elderly patients with lumbar osteoarthritis admitted to our hospital from January 2016 to June 2018 were randomly divided into the control group and the observation group, with 60 patients in each group. Patients in the control group were treated with etoricoxib, while patients in the observation group were treated with etoricoxib plus Yaotongning capsule orally. Both groups received medications for 2 weeks. Spinal pain and quality of life score changes were recorded. The inflammatory cytokines in serum TNF-α, GM-CSF, COX-2 and BMP-2 levels were monitored. The clinical efficacy was compared and drug safety profile was evaluated for two groups. Results The effective rates of the control group and the observation group were 78.33% and 91.67% respectively. The effective rate in the observation group weas significantly higher (P<0.05). After treatment, the VAS score for the patients in the observation group was significantly lower than that in the control group (P<0.05). The SF-36 score in the observation group was significantly increased (P<0.05), and the levels of TNF-α,GM-CSF and COX-2 in the serum were significantly lower than those in the control group (P<0.05), and the levels of BMP-2 were significantly increased (P<0.05). Conclusion Yaotongning capsule combined with etoricoxib in the treatment of senile lumbar osteoarthritis has definite curative effect. It significantly reduced lumbar pain, improved quality of life, inhibited inflammatory reaction, and had a better drug safety profile. The further clinical investigation for the combination therapy is warranted.

A possible case of etoricoxib induced fixed drug eruption

Fixed drug eruption (FDE) is a most commonly with adverse drug reaction seen with use of Non-steroidalanti-inflammatory drugs (NSAIDs) in particular nimesulide followed by antibiotics and anticonvulsants. Etoricoxib is a selective cyclo-oxygenase isoenzyme-2 inhibitor which is superior to conventional NSAIDs and causes less side effects. Authors present a case of fixed drug eruption due to etoricoxib in a male patient. A 50-year-old patient presented to Outpatient Department (OPD) of Dermatology of a Tertiary Care Hospital with complains of skin rashes over lips, oral cavity, trunk, both the upper and lower limbs, palm, soles, scrotum and glans penis since a week. The detailed history of the patient revealed the use of etoricoxib a week back, prescribed for low back pain. It was suspected that the cutaneous drug reaction was due to the use of etoricoxib. The suspected drug etoricoxib was stopped, patient was admitted and managed symptomatically. The above reaction was assessed to be “possible” as per WHO-UMC and Naranjo causality scale, “moderate” on Hartwig’s scale and “Probably preventable” according to Schumock and Thornton criteria. This case reporting was done to sensitize the prescribers regarding rare side effects of the above drug and the need to confirm past history of drug reaction before prescription.

Comparative study of effectiveness and safety of nonsteroidal anti-inflammatory drugs in patients of knee joint osteoarthritis of knee, tertiary care hospital, Bidar, India

Background: Osteoarthritis (OA) is a joint failure and OA is the most frequent chronic joint disease causing pain and disability. Where all the structures of joints have undergone pathological changes and they are hyaline articular cartilage loss which may be focal or non-uniform, initially it will be focal then spread all over non-uniformly. Non-Steroidal Anti Inflammatory Drugs (NSAID) are the mainstay of medical management of OA. Increased in reports suggests that GIT adverse effect with old NSAID’s and cardiovascular effects with selective cyclooxygenase-2 (COX2) inhibitors had precipitated to chase for better NSAID’s with minimal adverse effects. The current study compares the clinical effectiveness and safety of newer NSAID’s, etoricoxib, lornoxicam, to diclofenac which has been standard therapy in patients of OA of the knee joint.Methods: The current study is randomized, prospective, open-label, parallel group study conducted in 120 patients with OA of the knee joint diagnosed using American College of Rheumatology criteria. After getting the informed consent, they were randomized in three groups of 40 patients each who received tablet etoricoxib 120mg BID, tablet Lornoxicam 16mg BID, tablet diclofenac 50mg TID respectively. The duration of the study is 12 weeks. Data are calculated, tabulated and analyzed using analysis of variance (ANOVA) test, and level of significance was determined by its P value.Results: After 12weeks of treatment, the severity of pain and functional indices using visual analog scale and Western Ontario and McMaster Universities Osteoarthritis score were significantly better (P <0.05) in etoricoxib group as compared to lornoxicam or diclofenac group along with a lesser rate of adverse effects.Conclusions: It is concluded that etoricoxib is more effective and tolerated NSAID than lornoxicam and diclofenac in the treatment of knee joint OA.

Determination of the related substances in the etoricoxib tablets by HPLC / 国际药学研究杂志

Objective: To establish and validate a high performance liquid chromatography(HPLC)method for the determination of related substances in etoricoxib tablets. Methods: The related substances in the etoricoxib tablets were determined by HPLC. The Waters C18 column(4.6 mm×150 mm,3.5 μm)was used. The mobile phase consisted of the aqueous 0.02 mol/L sodium dihydrogen phosphate solution and acetonitrile(71:29,V/V)and the flow rate was 0.6 ml/min. The detection wavelength was 235 nm. The column temperature was 40℃ and the injection volume was 10 μl. Results: The etoricoxib related substances and other degraded substances in the forced degradation test of etoricoxib were com- pletely separated under the HPLC conditions. The quantification limit and the detection limit were 0.5 ng and 1.0 ng both for etoricoxib and its N-oxide,respectively. The calibration curves showed a good linearity within the range of 61.14- 152.85 μg/ml for etoricoxib and 61.50-153.75 μg/ml for the N-oxide. The recoveries of etoricoxib and its N-oxide were both within the range of 98%-102%. The solution used for determining the related substances were kept stable within 12 h at room temperature. Conclusion: The established HPLC method showed good specificity,sensitivity and accuracy,which could be used for the determination of related substances in the etoricoxib tablets.

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

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.

Clinical Study of Xiezhuo Zhubi Decoction Combined with Etoricoxib in Treating Acute Gout Arthritis / 广州中医药大学学报

Objective To observe the clinical efficacy of Xiezhuo Zhubi Decoction combined with Etoricoxib for the treatment of acute gout arthritis.Methods Seventy acute gout arthritis patients were randomly divided into treatment group and control group,35 cases in each group.Based on the fundamental treatment,the control group were given oral use of Etoricoxib and the treatment group was treated with Xiezhuo Zhubi Decoction combined with Etoricoxib.The treatment for both group lasted for 7 days.Before and after treatment,the changes of blood uric acid,C-reactive protein and erythrocyte sedimentation rate in both groups were observed.After treatment,the clinical efficacy was evaluated,and the toxic and adverse effects were also monitored.Results (1) In the treatment group,the total effective rate was 91.4％;in the control group,the total effective rate was 71.4％.There were significant differences between the two groups(P ＜ 0.05).(2) After treatment,blood uric acid,C-reactive protein and blood sedimentation rate were much improved in both groups (P ＜ 0.05 compared with those before treatment),and the treatment group had better effect on improving blood uric acid and C-reactive protein(P ＜ 0.05).(3) The control group had 3 cases of nausea,while no adverse reactions occurred in the treatment group.Conclusion Xiezhuo Zhubi Decoction combined with Etoricoxib is effective for the treatment of acute gout arthritis,and its effects on relieving clinical symptoms and decreasing blood uric acid and erythrocyte sedimentation rate are better than Etoricoxib alone.

Professor YU Jiangyi's Experience in Treating SAT / 浙江中医药大学学报

[Objective]To summarize the clinical experience of Professor YU Jiangyi in the treatment of subacute thyroiditis.[Methods]This article expounds professor YU Jiangyi's experience in treating this disease from the aspects of etiology and pathogenesis of SAT, traditional western medicine therapy and traditional Chinese medicine therapy, integrated traditional Chinese and western medicine therapy, TCM syndrome differentiation ,stage of SAT and so on. In order to better describe this therapy, clinical cases were reported.[Results]Under the guidance of the theory of traditional Chinese medicine, Professor YU Jiangyi thought that the cause of the disease was mainly emotional internal injury, deficiency of Qi and blood, coupled with the feeling of external evil or exerting internal injuries. And the clinical symptoms of SAT were reduced to heat warm, stagnation of Qi and fire or stagnation of Qi and phlegm obstruction and syndrome of deficiency of Qi and Yin in two. In combination with modern medical knowledge, Professor YU Jiangyi put forward the combination of traditional Chinese medicine and non-steroidal anti-inflammatory drugs. Professor YU Jiangyi used the method of clearing away heat and detoxicating, detumescence, and Etoricoxib in the treatment of SAT. In clinically, the curative effect was remarkable. [Conclusion]Professor YU Jiangyi's combination of clearing away heat and toxic swelling and Etoricoxib is effective, urgent treatment with western medicine, treating the root for slow disease with Chinese medicine, and worthy of inheritance and promotion.

Cardiovascular and Gastrointestinal Effects of Etoricoxib in the Treatment of Osteoarthritis: A Systematic Review and Network Meta-analysis

OBJECTIVE: To estimate the cardiovascular (CV) and gastrointestinal (GI) risks of etoricoxib in the treatment of osteoarthritis (OA) compared to a placebo and other non-steroidal anti-inflammatory drugs (NSAIDs). METHODS: A systematic review of randomized, controlled trials (RCTs) of etoricoxib were performed. Bayesian network meta-analysis was used over a duration of 12 weeks. The incidence of CV and GI events for a duration ≥26 weeks were also tabulated and presented using descriptive statistics. RESULTS: From this search, 10 studies were identified. Of these, 6 and 5 RCTs that measured the CV and GI events at 12 weeks were included in meta-analysis. They showed that etoricoxib did not increase the CV events compared to the placebo or NSAIDs during the 12 week period (odds ratio [OR]=0.59 compared to celecoxib, OR=0.89 with ibuprofen, OR=0.70 with placebo, and OR=2.16 with naproxen). The risk of GI events was comparable to that of most comparators, with the exception of naproxen, which had a significantly lower risk of GI events (OR=0.18) during the 12 week period. For a duration ≥26 weeks, the incidence of CV and GI events with etoricoxib increased with increasing duration. CONCLUSION: Etoricoxib is an alternative short-term treatment option for OA, showing comparable CV and GI complications to other NSAIDs. Nevertheless, further studies will be needed to elucidate the long-term safety of etoricoxib in the treatment of OA.

Effect of etoricoxib on experimental oxidative testicular ischemia-reperfusion damage in rats induced with torsion-detorsion

Etoricoxib features antioxidant and anti-inflammatory properties concomitantly, suggesting that it may be beneficial in testicular ischemia reperfusion (I/R) damage. Our aim is to investigate the effects of etoricoxib on testicular I/R damage induced with torsion-detorsion (TD). The etoricoxib + torsion-detorsion (ETD) groups of animals were given etoricoxib in 50 and 100 mg/kg of body weight (ETD-50 and ETD-100), while the testes torsion-detorsion (TTD) and sham operation rat group (SOG) animals were given single oral doses of distilled water as a solvent. TTD, ETD-50 and ETD-100 groups were subjected to 720° degrees torsion for four hours, and detorsion for four hours. The SOG group was not subjected to this procedure. Biochemical, gene expression and histopathological analyses were carried out on the testicular tissues. The levels of malondialdehyde (MDA), myeloperoxidase (MPO), interleukin-1 beta (IL-1β) and tumor necrosis factor alpha (TNF-α) were significantly higher, and the levels of total glutathione (tGSH) and glutathione reductase (GSHRd) were significantly lower in the TTD group, compared to the ETD-50, ETD-100 and SOG groups. Etoricoxib at a dose of 100 mg/kg better prevented I/R damage than the 50 mg/kg dose. Etoricoxib may be useful in clinical practice in the reduction of I/R damage on testes caused by torsion-detorsion.

Formulation and Evaluation of Solid Lipid Nanoparticle (SLN) Based Topical Gel of Etoricoxib.

The objective of present investigation was to prepare & evaluate solid lipid nanoparticle (SLN) based topical gel of non- steroidal anti-inflammatory drug (NSAID) etoricoxib for the treatment of arthritis which would attenuate the gastrointestinal related toxicities associated with oral administration. SLN were formulated by melt emulsification and solidification at low temperature method using stearic acid & tween 80. All the formulation were subjected to particle size, particle size distribution, zeta potential, scanning electron microscopy, crystallinity study by DSC and in-vitro release studies. It has been observed that, the high lipid concentration containing formulation have higher entrapment as compare to other two formulation. The SLN- dispersion shows 70.766% entrapment & zeta potential of the formulation were -25.6 which indicates the stability of formulation. The In Vitro drug release rate of gel was evaluated using Modified franz diffusion cell containing dialysis membrane with phosphate buffer pH 7.4 as the receptor medium. The in-vitro release was carried out in comparison with a carbopol gel & hydroxypropylmethylcellulose (HPMC) gel. The permeability parameters steady-state flux (Jss) was significantly increased in SLN-F3C (carbopol) formulation as compared with SLN-F3HPMC (hydroxypropyl methylcellulose) formulation. It was concluded that the Etoricoxib loaded SLN based gel formulation containing carbopol was suitable for topical application and shows much better result of anti-inflammatory activity.

Effect of etoricoxib on IL-1βand TNF-αwith gouty arthritis / 中国生化药物杂志

Objective To study effect of etoricoxib on IL-1βand TNF-αin patients with gouty arthritis.Methods 86 patients with gouty arthritis from July 2014 to July 2016 in our hospital were selected, all patients were divided into study group and control group according to the treatment method with 43 cases in each group.The patients in the control group were treated with diclofenac sodium, the patients in the study group were treated with etoricoxib.The clinical symptoms, clinical treatment effects, VAS score, serum IL-1β, TNF-αlevels and adverse reactions were observed and compared between the two groups.Results The VAS score, the joint swelling score and the mobility limitation score of the study group were decreased than before treatment and significantly lower than those of the control group, the difference was statistically significant (P<0.05).The effective rate of the study group (95.35%) was significantly higher than that of the control group (79.07%), the difference was statistically significant(P<0.05).The levels of IL-1βand TNF-αin the two groups were significantly lower than before treatment and the levels of IL-1βand TNF-αin the study groups were significantly lower than those in the control group,the difference was statistically significant(P<0.05).The incidence of adverse reactions in the study group was lower than that in the control group, the difference was statistically significant(P<0.05).Conclusion The clinical efficacy of etoricoxib in treating patients with gouty arthritis is significant, which can effectively relieve the clinical symptoms, inhibit the expression of IL-1βand TNF-α, and the adverse reactions less.

Clinical observation on Yishen Juanbi Capsule combined with Western medicine for treatment of elder-onset rheumatoid arthritis / 中草药

Objective: To investigate the clinical effect of Western medicine combined with Yishen Juanbi Capsule on elder-onset rheumatoid arthritis (EORA). Methods: A total of 46 patients who had EORA were randomly divided into treatment group and control group. The treatment group including 3 males and 23 females was treated with Methotrexate, 10 mg once a week, and Etoricoxib, 60 mg once a day, by oral administration treatment. The control group including 2 males and 18 females was treated with Yishen Juanbi Capsule, four capsules per time, three times per day on the base of treatment group. The clinical effect and medicinal incidences of adverse effect in 4, 8, and 12 weeks were respectively investigated. Results: There was a significant difference between the treatment group and control group (P0.05). Conclusion: The clinical effect of Western medicine combined with Yishen Juanbi Capsule used in the treatment of the EORA is significant and safe.

Evaluation of the Efficacy of Methylprednisolone, Etoricoxib and a Combination of the Two Substances to Attenuate Postoperative Pain and PONV in Patients Undergoing Laparoscopic Cholecystectomy: A Prospective, Randomized, Placebo-controlled Trial

BACKGROUND: Establishment of laparoscopic cholecystectomy as an outpatient procedure has accentuated the clinical importance of reducing early postoperative pain, as well as postoperative nausea and vomiting (PONV). We therefore planned to evaluate the role of a multimodal approach in attenuating these problems. METHODS: One hundred and twenty adult patients of ASA physical status I and II and undergoing elective laparoscopic cholecystectomy were included in this prospective, randomized, placebo-controlled study. Patients were divided into four groups of 30 each to receive methylprednisolone 125 mg intravenously or etoricoxib 120 mg orally or a combination of methylprednisolone 125 mg intravenously and etoricoxib 120 mg orally or a placebo 1 hr prior to surgery. Patients were observed for postoperative pain, fentanyl consumption, PONV, fatigue and sedation, and respiratory depression. Results were analyzed by the ANOVA, a Chi square test, the Mann Whitney U test and by Fisher's exact test. P values of less than 0.05 were considered to be significant. RESULTS: Postoperative pain and fentanyl consumption were significantly reduced by methylprednisolone, etoricoxib and their combination when compared with placebo (P0.05). The methylprednisolone and methylprednisolone + etoricoxib combination significantly reduced the incidence and severity of PONV and fatigue as well as the total number of patients requiring an antiemetic treatment compared to the placebo and etoricoxib (P<0.05). CONCLUSIONS: A preoperative single-dose administration of a combination of methylprednisolone and etoricoxib reduces postoperative pain along with fentanyl consumption, PONV, antiemetic requirements and fatigue more effectively than methylprednisolone or etoricoxib alone or a placebo.

Observation on the curative effect of neurotropin combined with etoricoxib in the treatment of pain in patients with ankylosing spondylitis / 中国基层医药

Objective To discuss the curative effect of neurotropin combined with etoricoxib in the treatment of pain in patients with ankylosing spondylitis (AS).Methods 30 AS patients were randomly divided into two groups.The control group was treated with 7.2Nu neurotropin injection for two weeks.The observation group was given neurotropin injection and 60mg etoricoxib tablets oral per day for two weeks.The Bath AS activity index(BASDAI),Bath AS functional index (BASFI),rachiodynia,hypnalgia and morning stiffness were observed.Results The total effective rate of observation group was superior to the control group,the difference was significant (P ＜ 0.05).No severe adverse reaction was observed.Conclusion Neurotropin combined with etoricoxib has definite effect on AS.

The clinical study of etoricoxib in the treatment of Chinese patients with osteoarthritis / 中华风湿病学杂志

Objective To compare the clinical response with etoricoxib 60 mg once daily with diclofenac sodium tablet 75 mg two times daily in the treatment of osteoarthritis of the knee or hip joint.Methods A 4-week multicenter,randomized,double-blinded and active comparator-controlled clinical trial was performed during January 2005 and June 2005 in 6 medical centers in China.Eligible patients (≥40 years old Chinese patients with osteoarthritis of the knee and hip) were randomized (1:1 ratio) to receive etoricoxib 60 mg once daily (n=90),or diclofenac sodium 75 mg twice daily (n=90).Primary efficacy end point is the change of WOMAC (Western Ontario and McMaster Universities osteoarthritis index) pain subscale from baseline to 4 weeks; non-inferiority bounds were pre-defined [if the upper bound of 95％ confidence interval (CI) for the difference is less than 10 mm on a 100-mm VAS WOMAC pain subscale] for the comparison of the change between the two groups.The secondary efficacy endpoints include WOMAC physical function subscale,WOMAC stiffness subscale,patient's global assessment of response to therapy (PGART),investigator's global assessment of disease status (IGADS),discontinuation due to lack of efficacy and rescue paracetamol tablet count.Safety was assessed by physical examination,adverse experience reported,and laboratory safety data.Results C6mpared to baseline,the changes of WOMAC pain subscale after 4 weeks treatment were statistically significant (P＜0.01) in both groups (etoricoxib group:51±16 vs 21± 19; diclofenac sodium group:53±16 vs 22±19).There was no difference in the change of WOMAC pain subscale between the two groups.The change in WOMAC stiffness subscale,WOMAC physical function subscale,PGART and IGADS in both groups were statistically significant (P＜0.01),but there was no difference between treatment groups according to the pre-defined non-inferiority criteria.No drug related serious adverse events were observed during the study.The difference in drug-related adverse event incidence between the two groups was not statistically significant.Etoricoxib and diclofenac sodium were generally safe and well tolerated.Conclusion Etoricoxib 60 mg administered once daily is efficacious and shows clinical efficacy notinferior to that of diclofenac sodium 75 mg administered twice daily for the treatment of osteoarthritis.Etoricoxib 60 mg administered once daily for 4 weeks is generally safe and well tolerated.