Safety Of Anti-inflammatory Drugs Research Articles

Safety of anti-inflammatory drugs in children with asthma.

Inhaled corticosteroids (ICS) are widely used as the first-line treatment of asthma. When the disease is not controlled by standard doses of ICS, other anti-inflammatory drugs should be considered. The aim of this report is to review the main adverse events induced by anti-inflammatory drugs in children with asthma and discuss possible actions to prevent or mitigate these effects. Proper interpretation of ICS safety studies requires knowledge of the pharmaceutical properties and delivery device systems of the different ICS available. Genetic variants affecting susceptibility to corticosteroid-induced adrenal suppression were found in children and adults who use ICS to treat their asthma. There is evidence of the association between montelukast use and neuropsychiatric events. Benefits of ICS, properly prescribed and used, outweigh their potential adverse effects. There is substantial evidence that the combination of ICS with long-acting beta2 agonists is safe for asthmatic children. Awareness of the potential risks of neuropsychiatric events in children taking montelukast should inform the clinicians' prescribing practices. Omalizumab is generally well-tolerated, but the evidence on the safety of other biologic agents in children is scanty. The risk of systemic adverse events with anti-inflammatory drugs must be balanced against the risks of uncontrolled asthma and/or frequent oral steroid use.

Anti-inflammatory activity of a combined gel based on plant components in a model of adjuvant arthritis in rats

Topicality. According to WHO, more than 4 % of the population globe suffer from a variety of joint and spine disorders. In Ukraine, more than 34,500 patients with primary joint diseases are registered annually. Diseases of the musculoskeletal system have a chronic course that requires long-term treatment and puts increased demands on the effectiveness and safety of anti-inflammatory drugs. Therefore, the above justifies the feasibility and relevance of the search for new highly effective and safe domestic drugs.Aim. To make an experimental study of the pharmacological activity of a combined gel for the treatment of inflammatory joint disease if chronic inflammation – adjuvant arthritis in rats.Materials and methods. The subjects of the study were model samples of a combined gel with active pharmaceutical ingredients - white willow bark, common sage leaves dried extract and methyl salicylate. The anti-inflammatory properties of the new gel were studied using a model of adjuvant arthritis in rats (sensitization to the base of the tail by PAF at 0.1 ml/animal, and the introduction on the seventh day of a resolving dose by PAF 0.1 ml/animal under aponeurosis of the right hind limb subplantarly). Diclofenac sodium gel, 5 %, was used as the comparison drug. The test specimens were applied to the affected paw surface daily at a dose of 0.2 ml/animal. Indicators: volume of edema of animal paws (3, 7, 10, 14 and 21 days of experiment); leukocyte and FAN content in the blood and alkaline and acid phosphatase activity and serum CIK content (21 days).Results and discussion. According to the results of studies, against the background of chronic inflammation, the combined gel shows an efficiency comparing to the diclofenac sodium gel, 5 %, conceding to it only in its anti-exudative effect. However, a positive feature of the new gel, in contrast to the drug of comparison, is the ability to maintain the cellular level of non-specific animal immunity, which is significantly impaired under the condition of this pathology.Conclusions. The obtained experimental data substantiate the prospect of further pharmacological studies of the developed combination gel based on the active ingredients of white willow bark, sage medicinal leaves dried extract and methyl salicylate.

Meta analysis of efficacy and safety of non-steroidal anti-inflammatory drugs in preventing heterotopic ossification after hip arthroscopy

Objective To evaluate the efficacy and safety of non-steroidal anti-inflammatory drugs (NSAIDs) in preventing heterotopic ossification after hip arthroscopy. Methods Literature search was conducted in PubMed, Embase, Cochrane Library, CNKI and Wanfang data with time range from January 1973 to November 2017. Clinical case control articles on NSAIDs in preventing heterotopic ossification after hip arthroscopy were screened based on the inclusion and exclusion criteria. Meta analysis was done using RevMan 5.3 software to investigate the incidence of complications such as heterotopic ossification and gastrointestinal bleeding after hip arthroscopy in patients taking NSAIDs orally. Results Six articles were included in the study, with a total of 754 cases and 536 controls. NSAIDs reduced the incidence of heterotopic ossification after hip arthroscopy (RR=0.09, 95%CI 0.03-0.27, P 0.05). Conclusion NSAIDs can effectively reduce the incidence of heterotopic ossification after hip arthroscopy and does not increase the incidence of postoperative gastrointestinal complications. Therefore, it is effective and safe to use NSAIDs to prevent the occurrence of heterotopic ossification after hip arthroscopy. Key words: Arthroscopy; Hip; Ossification, heterotopic; Anti-inflammatory agents, non-steroidal; Meta analysis

Safety of Aspirin Plus NSAIDs in Patients at Increased Cardiovascular Risk

The double-blind PRECISION evaluated the cardiovascular safety of nonsteroidal anti-inflammatory drugs (NSAIDs) in patients with osteoarthritis or

Pharmacogenetics and pharmacogenomics in rheumatology

Pharmacogenetics and pharmacogenomics deal with possible associations of a single genetic polymorphism or those of multiple gene profiles with responses to drugs. In rheumatology, genes and gene signatures may be associated with altered efficacy and/or safety of anti-inflammatory drugs, disease-modifying antirheumatic drugs (DMARDs) and biologics. In brief, genes of cytochrome P450, other enzymes involved in drug metabolism, transporters and some cytokines have been associated with responses to and toxicity of non-steroidal anti-inflammatory drugs, corticosteroids and DMARDs. The efficacy of biologics may be related to alterations in cytokine, chemokine and FcγR genes. Numerous studies reported multiple genetic signatures in association with responses to biologics; however, data are inconclusive. More, focused studies carried out in larger patient cohorts, using pre-selected genes, may be needed in order to determine the future of pharmacogenetics and pharmacogenomics as tools for personalized medicine in rheumatology.

The Use of Anti-inflammatory Medications in Cystic Fibrosis: Trends and Physician Attitudes

In recent years, there has been considerable interest in the use of antiinflammatory medications to decrease airway inflammation and preserve pulmonary function in patients with cystic fibrosis (CF) lung disease. Long-term use of oral corticosteroids (OCS) and ibuprofen (IBU) has been proven efficacious in slowing the progression of CF. Inhaled corticosteroids (ICS) have not been adequately studied. Little is known regarding use trends and physician attitudes toward these drugs. Cross-sectional survey mailed to 111 directors of Cystic Fibrosis Centers in the United States accredited by the Cystic Fibrosis Foundation. The two-page written questionnaire included items regarding physicians' attitudes toward anti-inflammatories, center demographics, patients receiving therapy, and number of physicians prescribing therapy. Sixty-seven surveys were returned (60%). The responding centers represented 239 physicians and served 9,363 patients, 2,234 (24%) of whom were receiving routine antiinflammatory drugs. Complete data sets were available for 8,803 patients with 2,169 (25%) receiving anti-inflammatory therapy. Ninety-eight (41%) physicians prescribed long-term use of oral steroids for 413 (5%) patients, 103 (42%) prescribed inhaled steroids for 1,032 (12%) patients, and 108 (45%) prescribed high-dose IBU for 723 (8%) patients to control CF. The practitioners reported familiarity and efficacy as the primary reasons for prescribing OCS; concerns over side effects were the major reason for not prescribing. Regarding ICS, the primary reasons for prescribing were familiarity and safety, with lack of efficacy being cited as the major reason for not prescribing. For IBU, efficacy was ranked highest among reasons for prescribing, with concern over safety being the highest ranked reason for not prescribing. Anti-inflammatory medications appear to be an underutilized therapeutic modality in CF care. This is true for numbers of patients receiving these drugs as well as numbers of care providers prescribing them. Additional studies will be required to address physicians' concerns regarding the long-term efficacy and safety of anti-inflammatory drugs in treating CF.