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Декскетопрофен: возможности применения в неврологии
Декскетопрофен: возможности применения в неврологии
Пилипович А.А. Декскетопрофен: возможности применения в неврологии. Consilium Medicum. 2018; 20 (9): 71–75. DOI: 10.26442/2075-1753_2018.9.71-75
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Аннотация
На сегодняшний день основой терапии острого болевого синдрома любой степени выраженности остаются нестероидные противовоспалительные препараты (НПВП). В практике клинического невролога наиболее часто НПВП используются для лечения заболеваний опорно-двигательного аппарата и купирования головных болей. Задача заключается в том, чтобы правильно выбрать препарат для пациента, учитывая все показания и противопоказания, адекватно подобрать дозу или комбинацию нескольких анальгетиков. При этом желательно использовать препарат с максимальной скоростью развития противоболевого эффекта и минимальным риском осложнений со стороны желудочно-кишечного тракта без ущерба для эффективности. Одним из таких представителей группы НПВП является декскетопрофена трометамол – правовращающий изомер кетопрофена. Препарат обладает высокой степенью очистки от R(-)-кетопрофена (99,9%), имеет улучшенные физико-химические свойства. В статье разбираются механизмы его действия, приводятся данные клинических исследований, демонстрирующие анальгетическую эффективность и переносимость декскетопрофена трометамола (препарат Дексалгин®) по основному показанию к применению препарата в неврологии – скелетно-мышечные боли, а также головные боли мигренозного характера.
Ключевые слова: боль в спине, скелетно-мышечные боли, декскетопрофена трометамол, Дексалгин, мигрень.
Key words: back pain, musculoskeletal pain, dexketoprofen trometamol, Dexalgin, migraine.
Ключевые слова: боль в спине, скелетно-мышечные боли, декскетопрофена трометамол, Дексалгин, мигрень.
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Key words: back pain, musculoskeletal pain, dexketoprofen trometamol, Dexalgin, migraine.
Полный текст
Список литературы
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32. Allais G, Bussone G, Tullo V et al. Frovatriptan 2.5 mg plus dexketoprofen (25 mg or 37.5 mg) in menstrually related migraine. Subanalysis from a double-blind, randomized trial. Cephalalgia 2015; 35 (1): 45–50.
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4. Barbanoj MJ, Gich I, Artigas R et al. Pharmacokinetics of dexketoprofen trometamol in healthy volunteers after single and repeated oral doses. Drugs 1998; 52 (Suppl. 5): 24–45.
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8. Zippel H, Wagenitz A. Comparison of the efficacy and safety of intravenously administered dexketoprofen trometamol and ketoprofen in the management of pain after orthopaedic surgery: A multicentre, double-blind, randomised, parallelgroup clinical trial. Clin Drug Investig 2006; 26: 517–28.
9. Zapata A, Cegarra F, Artigas R, Keller F. Dexketoprofen vs tramadol: randomised double-blind trial in patients with postoperative pain. British J Clin Pharmacol 2000; 223: abs 870.
10. Hanna MH, Elliott KM, Stuart-Taylor ME et al. Comparative study of analgesic efficacy and morphine-sparing effect of intramuscular dexketoprofen trometamol with ketoprofen or placebo after major orthopaedic surgery. Br J Clin Pharmacol 2003; 55: 126–133.
11. Jackson ID, Heidemann BH, Wilson J et al. Doubleblind, randomized, placebo-controlled trial comparing rofecoxib with dexketoprofen trometamol in surgical dentistry. Br J Anaesth 2004; 92: 675–80.
12. McGurk M, Robinson P, Rajayogeswaran V et al. Clinical comparison of dexketoprofen trometamol, ketoprofen, and placebo in postoperative dental pain. J Clin Pharmacol 1998; 38 (Suppl. 12): 46S–54S.
12. McGurk M, Robinson P, Rajayogeswaran V et al. Clinical comparison of dexketoprofen trometamol, ketoprofen, and placebo in postoperative dental pain. J Clin Pharmacol 1998; 38 (Suppl. 12): 46S–54S.
13. Munoz G, Berini L, Sanchez S et al. Preoperative dexketoprofen trometamol for the prevention of postoperative dental pain: a randomised double-blind clinical trial. Method Find Exp Clin Pharmacol 1998; 20 (Suppl A): 69.
14. Sanchez-Carpena J, Dominguez-Hervella F, Garcia I et al; Dexketoprofen Renal Colic Study Group. Comparison of intravenous dexketoprofen and dipyrone in acute renal colic. Eur J Clin Pharmacol 2007; 63 (8): 751–60.
15. Zippel H, Wagenitz A. A multicentre, randomised, double-blind study comparing the efficacy and tolerability of intramuscular dexketoprofen versus diclofenac in the symptomatic treatment of acute low back pain. Clin Drug Investig 2007; 27: 533–43.
16. Metscher B, Kubler U, Jahnel-Kracht H. Dexketoprofen-trometamol and tramadol in acute lumbago. Fortschr Med Orig 2001; 118: 147–51.
17. Marenco JL, Pérez M, Navarro FJ et al. A multicentre, randomised, double-blind study to compare the efficacy and tolerability of dexketoprofen trometamol versus diclofenac in the symptomatic treatment of knee osteoarthritis. Clin Drug Invest 2000; 19: 247–56.
18. Ezcurdia M, Cortejoso FJ, Lanzon R et al. Comparison of the efficacy and tolerability of dexketoprofen and ketoprofen in the treatment of primary dysmenorrhea. J Clin Pharmacol 1998; 38 (Suppl. 12): 65S–73S.
19. Rodriguez MJ, Contreras D, Galvez R et al. Double-blind evaluation of short-term analgesic efficacy of orally administered dexketoprofen trometamol and ketorolac in bone cancer pain. Pain 2003; 104: 103–10.
20. Leman P, Kapadia Y, Herington J. Randomised controlled trial of the onset of analgesic efficacy of dexketoprofen and diclofenac in lower limb injury. Emerg Med J 2003; 20: 511–3.
19. Rodriguez MJ, Contreras D, Galvez R et al. Double-blind evaluation of short-term analgesic efficacy of orally administered dexketoprofen trometamol and ketorolac in bone cancer pain. Pain 2003; 104: 103–10.
20. Leman P, Kapadia Y, Herington J. Randomised controlled trial of the onset of analgesic efficacy of dexketoprofen and diclofenac in lower limb injury. Emerg Med J 2003; 20: 511–3.
21. Beltra’n J et al. Comparison of Dexketoprofen trometamol and ketoprofen in the treatment of osteoartritis of the knee. J Clin Pharmacol 1998; 38: 74S–80S.
22. Capriai A, Mas M, Bertoloti M et al. Intramuscular dexketoprofen trometamol in acute lower back pain. 10th World Congress on Pain, IASP, California, 2002; p. 108–12.
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28. Krymchantowski AV, Jevoux CC. The experience of combining agents, specially triptans and non steroidal anti-inflammatory drugs, for the acute treatment of migraine – a review. Recent Pat CNS Drug Discov 2007; 2: 141–4.
29. Tullo V, Valguarnera F, Barbanti P et al. Comparison of frovatriptan plus dexketoprofen (25 mg or 37.5 mg) with frovatriptan alone in the treatment of migraine attacks with or without aura: A randomized study. Cephalalgia 2014; 34: 434–45.
30. Allais G, Rolando S, Schiapparelli P et al. Frovatriptan plus dexketoprofen in the treatment of menstrually related migraine. An open study. Neurol Sci 2013; 34 (Suppl. 1): S179–S181.
31. Elkind AH and MacGregor EA. Frovatriptan for the acute treatment of migraine and prevention of predictable menstrual migraine. Expert Rev Neurother 2008; 8: 723–36.
32. Allais G, Bussone G, Tullo V et al. Frovatriptan 2.5 mg plus dexketoprofen (25 mg or 37.5 mg) in menstrually related migraine. Subanalysis from a double-blind, randomized trial. Cephalalgia 2015; 35 (1): 45–50.
________________________________________________
2. Ryabokon I.V. Sovremennyj vzglyad na lechenie boli v spine. Handbook for Practitioners Doctors. 2009; 3: 78–81. [in Russian] 3. Mauleon D, Artigas R, Garcнa ML, Carganico G. Preclinical and clinical development of dexketoprofen. Drugs 1996; 52 (Suppl. 5): 24–45.
4. Barbanoj MJ, Gich I, Artigas R et al. Pharmacokinetics of dexketoprofen trometamol in healthy volunteers after single and repeated oral doses. Drugs 1998; 52 (Suppl. 5): 24–45.
5. McEwen J, De Luca M, Casini A et al. The effect of food and an antacid on the bioavailability of dexketoprofen trometamol. J Clin Pharmacol 1998; 38 (Suppl. 12): 33S–40S.
6. Karneev A.N. The practice of treating back pain. Consilium Medicum. 2017; 19 (2.2. Neurology and Rheumatology): 32–6. [in Russian]
7. Moore RA, Barden J. Systematic review of dexketoprofen in acute and chronic pain. BMC Clin Pharmacol 2008; 8: 11.
8. Zippel H, Wagenitz A. Comparison of the efficacy and safety of intravenously administered dexketoprofen trometamol and ketoprofen in the management of pain after orthopaedic surgery: A multicentre, double-blind, randomised, parallelgroup clinical trial. Clin Drug Investig 2006; 26: 517–28.
9. Zapata A, Cegarra F, Artigas R, Keller F. Dexketoprofen vs tramadol: randomised double-blind trial in patients with postoperative pain. British J Clin Pharmacol 2000; 223: abs 870.
10. Hanna MH, Elliott KM, Stuart-Taylor ME et al. Comparative study of analgesic efficacy and morphine-sparing effect of intramuscular dexketoprofen trometamol with ketoprofen or placebo after major orthopaedic surgery. Br J Clin Pharmacol 2003; 55: 126–133.
11. Jackson ID, Heidemann BH, Wilson J et al. Doubleblind, randomized, placebo-controlled trial comparing rofecoxib with dexketoprofen trometamol in surgical dentistry. Br J Anaesth 2004; 92: 675–80.
12. McGurk M, Robinson P, Rajayogeswaran V et al. Clinical comparison of dexketoprofen trometamol, ketoprofen, and placebo in postoperative dental pain. J Clin Pharmacol 1998; 38 (Suppl. 12): 46S–54S.
13. Munoz G, Berini L, Sanchez S et al. Preoperative dexketoprofen trometamol for the prevention of postoperative dental pain: a randomised double-blind clinical trial. Method Find Exp Clin Pharmacol 1998; 20 (Suppl A): 69.
14. Sanchez-Carpena J, Dominguez-Hervella F, Garcia I et al; Dexketoprofen Renal Colic Study Group. Comparison of intravenous dexketoprofen and dipyrone in acute renal colic. Eur J Clin Pharmacol 2007; 63 (8): 751–60.
15. Zippel H, Wagenitz A. A multicentre, randomised, double-blind study comparing the efficacy and tolerability of intramuscular dexketoprofen versus diclofenac in the symptomatic treatment of acute low back pain. Clin Drug Investig 2007; 27: 533–43.
16. Metscher B, Kubler U, Jahnel-Kracht H. Dexketoprofen-trometamol and tramadol in acute lumbago. Fortschr Med Orig 2001; 118: 147–51.
17. Marenco JL, Pérez M, Navarro FJ et al. A multicentre, randomised, double-blind study to compare the efficacy and tolerability of dexketoprofen trometamol versus diclofenac in the symptomatic treatment of knee osteoarthritis. Clin Drug Invest 2000; 19: 247–56.
18. Ezcurdia M, Cortejoso FJ, Lanzon R et al. Comparison of the efficacy and tolerability of dexketoprofen and ketoprofen in the treatment of primary dysmenorrhea. J Clin Pharmacol 1998; 38 (Suppl. 12): 65S–73S.
19. Rodriguez MJ, Contreras D, Galvez R et al. Double-blind evaluation of short-term analgesic efficacy of orally administered dexketoprofen trometamol and ketorolac in bone cancer pain. Pain 2003; 104: 103–10.
20. Leman P, Kapadia Y, Herington J. Randomised controlled trial of the onset of analgesic efficacy of dexketoprofen and diclofenac in lower limb injury. Emerg Med J 2003; 20: 511–3.
21. Beltra’n J et al. Comparison of Dexketoprofen trometamol and ketoprofen in the treatment of osteoartritis of the knee. J Clin Pharmacol 1998; 38: 74S–80S.
22. Capriai A, Mas M, Bertoloti M et al. Intramuscular dexketoprofen trometamol in acute lower back pain. 10th World Congress on Pain, IASP, California, 2002; p. 108–12.
23. Metscher B, Kubler U et al. Dexketoprofen-trometamol and tramadol in acute lumbago. Fortschr Med Orig 2001; 118 (4): 147–51.
24. Podchufarova E.V. Opyt primeneniya preparata Deksalgin® pri lechenii ostryh skeletno-myshechnyh bolevyh sindromov. Effektivnaya farmakoterapiya. Nevrologiya i Psihiatriya. 2012; 2: 34–9. [in Russian]
25. Merkulov Yu.A., Merkulova D.M., Kryzhanovskij G.N. Effektivnost deksalgina na vertebrogennye i nevertebrogennye mehanizmy dizregulyacii pri bolyah v spine. Zhurn. nevrologii i psihiatrii im. S.S.Korsakova. 2006; 106 (5): 20–4. [in Russian]
26. Soloveva E.Yu., Karneev A.N., Fedin A.I. Sochetannoe primenenie deksalgina i nimesila v stadii obostreniya dorsopatii. Vrach. 2007; 3: 67–71. [in Russian]
27. Podchufarova E.V., Yahno N.N. Boli v spine i konechnostyah. V kn.: Bolezni nervnoj sistemy. Rukovodstvo dlya vrachej. Pod red. N.N.Yahno. T. 2. M., 2005; s. 306–31. [in Russian]
28. Krymchantowski AV, Jevoux CC. The experience of combining agents, specially triptans and non steroidal anti-inflammatory drugs, for the acute treatment of migraine – a review. Recent Pat CNS Drug Discov 2007; 2: 141–4.
29. Tullo V, Valguarnera F, Barbanti P et al. Comparison of frovatriptan plus dexketoprofen (25 mg or 37.5 mg) with frovatriptan alone in the treatment of migraine attacks with or without aura: A randomized study. Cephalalgia 2014; 34: 434–45.
30. Allais G, Rolando S, Schiapparelli P et al. Frovatriptan plus dexketoprofen in the treatment of menstrually related migraine. An open study. Neurol Sci 2013; 34 (Suppl. 1): S179–S181.
31. Elkind AH and MacGregor EA. Frovatriptan for the acute treatment of migraine and prevention of predictable menstrual migraine. Expert Rev Neurother 2008; 8: 723–36.
32. Allais G, Bussone G, Tullo V et al. Frovatriptan 2.5 mg plus dexketoprofen (25 mg or 37.5 mg) in menstrually related migraine. Subanalysis from a double-blind, randomized trial. Cephalalgia 2015; 35 (1): 45–50.
Авторы
А.А.Пилипович
ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М.Сеченова» Минздрава России. 119991, Россия, Москва, ул. Трубецкая, д. 8, стр. 2
aapilipovich@mail.ru
I.M.Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation. 119991, Russian Federation, Moscow, ul. Trubetskaia, d. 8, str. 2
aapilipovich@mail.ru
ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М.Сеченова» Минздрава России. 119991, Россия, Москва, ул. Трубецкая, д. 8, стр. 2
aapilipovich@mail.ru
________________________________________________
I.M.Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation. 119991, Russian Federation, Moscow, ul. Trubetskaia, d. 8, str. 2
aapilipovich@mail.ru
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