Использование нестероидных противовоспалительных препаратов в реальной клинической практике: новые возможности
Использование нестероидных противовоспалительных препаратов в реальной клинической практике: новые возможности
Каратеев А.Е. Использование нестероидных противовоспалительных препаратов в реальной клинической практике: новые возможности. Consilium Medicum. 2018; 20 (9): 88–94. DOI: 10.26442/2075-1753_2018.9.88-94
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Karateev A.E. Non-steroidal anti-inflammatory drugs use in clinical practice: new opportunities. Consilium Medicum. 2018; 20 (9): 88–94. DOI: 10.26442/2075-1753_2018.9.88-94
Использование нестероидных противовоспалительных препаратов в реальной клинической практике: новые возможности
Каратеев А.Е. Использование нестероидных противовоспалительных препаратов в реальной клинической практике: новые возможности. Consilium Medicum. 2018; 20 (9): 88–94. DOI: 10.26442/2075-1753_2018.9.88-94
________________________________________________
Karateev A.E. Non-steroidal anti-inflammatory drugs use in clinical practice: new opportunities. Consilium Medicum. 2018; 20 (9): 88–94. DOI: 10.26442/2075-1753_2018.9.88-94
Нестероидные противовоспалительные препараты (НПВП) – удобный и надежный инструмент анальгетической терапии. Они эффективно купируют боль и подавляют локальное воспаление, но, к сожалению, могут вызывать широкий спектр нежелательных реакций. И хотя сегодня в арсенале российского врача находится 28 различных наименований НПВП (многие из которых имеют десятки генериков), ни один из этих препаратов не может считаться идеальным по соотношению эффективности и безопасности. Это оправдывает появление новых представителей этой лекарственной группы. Так, в реальную клиническую практику нашей страны вновь входит теноксикам – препарат, хорошо известный врачам всего мира. Эффективность и безопасность теноксикама были подтверждены в ходе большого числа исследований. Но главным испытанием, которое препарат с успехом выдержал, стало его многолетнее применение в реальной медицинской практике. Терапевтические возможности теноксикама были показаны при ревматоидном артрите, анкилозирующим спондилите и подагре. Он успешно контролирует боль при наиболее распространенных ревматических заболеваниях – остеоартрите и неспецифической боли в спине. Теноксикам зарекомендовал себя в качестве эффективного компонента мультимодального периоперационного обезболивания в хирургической практике. Он также действенен при купировании боли в ургентных ситуациях: при острых травмах, зубной боли, почечной и желчной коликах. Теноксикам принимается один раз в сутки, имеет разные фармакологические формы и обладает благоприятным профилем безопасности. Несомненно, применение теноксикама расширяет возможности анальгетической терапии в практике врачей самых разных медицинских специальностей.
Non-steroidal anti-inflammatory drugs (NSAIDs) are considered safe and effective analgesics. These medications effectively reduce pain syndrome and suppress local inflammation but unfortunately may cause a wide range of adverse effects. Although there are 28 different NSAIDs registered in Russia (and many of them have dozens of generics), none of them can be considered ideal in terms of effectiveness and safety. It explains development of new drugs in this group. Nowadays tenoxicam is again included in clinical use in Russia. This medication is well known all over the world. Tenoxicam effectiveness and safety were acknowledged in many clinical trials. And its use in clinical practice for many years is the main test that the drug has successfully passed. Opportunities of tenoxicam therapeutic use were shown in patients with rheumatoid arthritis, ankylosing spondylitis and gout. It allows to successfully reduce pain in patients with most common rheumatic disorders such as osteoarthritis and non-specific back pain. Tenoxicam proved to be an effective component of combined perioperative anesthesia in surgical practice. It is also effective for pain relief in urgent situations such as acute injuries, toothache, renal or gallstone colic. Tenoxicam is administered once a day, it has different pharmacological forms and a favorable safety profile. Undoubtedly, tenoxicam inclusion in clinical practice increases opportunities of analgesic therapy in practical use for various medical professionals.
1. Каратеев А.Е., Насонов Е.Л., Ивашкин В.Т. и др. Рациональное использование нестероидных противовоспалительных препаратов. Клинические рекомендации. Научно-практическая ревматология. 2018; 56: 1–29. https://doi.org/10.14412/1995-4484-2018-1-29 / Karateev A.E., Nasonov E.L., Ivashkin V.T. i dr. Ratsional'noe ispol'zovanie nesteroidnykh protivovospalitel'nykh preparatov. Klinicheskie rekomendatsii. Nauchno-prakticheskaia revmatologiia. 2018; 56: 1–29. https://doi.org/10.14412/1995-4484-2018-1-29 [in Russian]
2. Makris UE, Abrams RC, Gurland B, Reid MC. Management of persistent pain in the older patient: a clinical review. JAMA 2014; 312 (8): 825–36. DOI: 10.1001/jama.2014.9405
3. Hunter TS, Robison C, Gerbino PP. Emerging evidence in NSAID pharmacology: important considerations for product selection. Am J Manag Care 2015; 21 (Suppl. 7): S139–47.
4. Xu S, Rouzer CA, Marnett LJ. Oxicams, a class of nonsteroidal anti-inflammatory drugs and beyond. IUBMB Life 2014; 66 (12): 803–11. DOI: 10.1002/iub.1334
5. Díaz-González F, Sánchez-Madrid F. NSAIDs: learning new tricks from old drugs. Eur J Immunol 2015; 45 (3): 679–86. DOI: 10.1002/eji.201445222
6. Vecchio AJ, Malkowski MG. The structural basis of endocannabinoid oxygenation by cyclooxygenase-2. J Biol Chem 2011; 286 (23): 20736–45. DOI: 10.1074/jbc.M111.230367
7. Vecchio AJ, Simmons DM, Malkowski MG. Structural basis of fatty acid substrate binding to cyclooxygenase-2. J Biol Chem 2010; 285 (29): 22152–63. DOI: 10.1074/jbc.M110.119867
8. Nilsen OG. Clinical pharmacokinetics of tenoxicam. Clin Pharmacokinet 1994; 26 (1): 16–43.
9. https://www.drugs.com/international/tenoxicam.html
10. http://www.ema.europa.eu/docs/en_GB/document_library/Periodic_safety_update_single_assessment/2016/1....
11. Lora M, Morisset S, Ménard HA et al. Expression of recombinant human cyclooxygenase isoenzymes in transfected COS-7 cells in vitro and inhibition by tenoxicam, indomethacin and aspirin. Prostaglandins Leukot Essent Fatty Acids 1997; 56 (5): 361–7.
12. Van Antwerpen P, Nève J. In vitro comparative assessment of the scavenging activity against three reactive oxygen species of non-steroidal anti-inflammatory drugs from the oxicam and sulfoanilide families. Eur J Pharmacol 2004; 496 (1–3): 55–61.
13. Ferrari GV, Natera J, Paulina Montaña M. Scavenging of photogenerated ROS by Oxicams. Possible biological and environmental implications. J Photochem Photobiol B 2015; 153: 233–9. DOI: 10.1016/j.jphotobiol.2015.09.024
14. Ozgocmen S, Ardicoglu O, Erdogan H et al. In vivo effect of celecoxib and tenoxicam on oxidant/anti-oxidant status of patients with knee osteoarthritis. Ann Clin Lab Sci 2005; 35 (2): 137–43.
15. Simpson J, Golding DN, Freeman AM et al. A large multicentre, parallel group, double-blind study comparing tenoxicam and piroxicam in the treatment of osteoarthritis and rheumatoid arthritis. Br J Clin Pract 1989; 43 (9): 328–33.
16. Moser U, Waldburger H, Schwarz HA, Gobelet CA. A double-blindrandomisedmulticentre study with tenoxicam, piroxicam and diclofenac sodium retard in the treatment of ambulant patients with osteoarthritis and extra-articular rheumatism. Scand J Rheumatol Suppl 1989; 80: 71–80.
17. Ejstrup L, Knudsen JV, Petersen L. A randomised double-blind multicentre trial comparing tenoxicam and ketoprofen in osteoarthritis. Scand J Rheumatol Suppl 1989; 80: 48–53.
18. Bellamy N, Buchanan WW, Chalmers A et al. A multicenter study of tenoxicam and diclofenac in patients with osteoarthritis of the knee. J Rheumatol 1993; 20 (6): 999–1004.
19. Riedemann PJ, Bersinic S, Cuddy LJ et al. A study to determine the efficacy and safety of tenoxicam versus piroxicam, diclofenac and indomethacin in patients with osteoarthritis: a meta-analysis. J Rheumatol 1993; 20 (12): 2095–103.
20. Langdon CG, Moran DG, Jamieson V et al. A multicentre study of tenoxicam for the treatment of osteo-arthritis and rheumatoid arthritis in general practice. J Int Med Res 1990; 18 (6): 489–96.
21. Kraag GR, Gordon DA, Ménard HA et al. Patient compliance with tenoxicam in family practice. Clin Ther 1994; 16 (3): 581–93.
22. Marcolongo R, Fioravanti A. Clinical experiences with tenoxicam. Preliminary results of a multicenter study. Recent Prog Med 1991; 82 (4): 242–9.
23. Ibrahima K, Kodjo G, Issa S et al. Clinical efficacy and tolerability of tenoxicam in African patients with osteoarthritis, rheumatoid arthritis, tendinitis and/or bursitis: an open study. Curr Med Res Opin 1991; 12 (7): 471–8.
24. Nived O, Sturfelt G, Eckernäs SA, Singer P. A comparison of 6 months' compliance of patients with rheumatoid arthritis treated with tenoxicam and naproxen. Use of patient computer data to assess response to treatment. J Rheumatol 1994; 21 (8): 1537–41.
25. Lund B, Andersen RB, Fossgreen J et al. A long-term randomised trial on tenoxicam and piroxicam in osteoarthritis of the hip or knee: a 24-month interim report focusing on the 12–24 month interval. Eur J Rheumatol Inflamm 1987; 9 (2): 58–67.
26. Lalos J, Tsachalos P, Gallis L. Long-term (four year) clinical trial with tenoxicam and basis therapy in patients suffering from rheumatoid arthritis. Scand J Rheumatol Suppl 1989; 80: 67–70.
27. Perez-Ruiz F, Alonso-Ruiz A, Ansoleaga JJ. Comparative study of the efficacy and safety of aceclofenac and tenoxicam in rheumatoid arthritis. Clin Rheumatol 1996; 15 (5): 473–7.
28. Villa Alcázar LF, de Buergo M, Rico Lenza H, Montull Fruitós E. Aceclofenac is as safe and effective as tenoxicam in the treatment of ankylosing spondylitis: a 3 month multicenter comparative trial. Spanish Study Group on Aceclofenac in Ankylosing Spondylitis. J Rheumatol 1996; 23 (7): 1194–9.
29. Valdés EF. Use of tenoxicam in patients with acute gouty arthritis. Eur J Rheumatol Inflamm 1987; 9 (2): 133–6.
30. Waterworth RF, Waterworth SM. An open assessment of tenoxicam (Tilcotil) in the treatment of acute gout in general practice. N Z Med J 1987; 100 (837): 744–5.
31. Van Durme CM, Wechalekar MD, Buchbinder R et al. Non-steroidal anti-inflammatory drugs for acute gout. Cochrane Database Syst Rev 2014; 9: CD010120. DOI: 10.1002/14651858.CD010120.pub2
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1. Karateev A.E., Nasonov E.L., Ivashkin V.T. i dr. Ratsional'noe ispol'zovanie nesteroidnykh protivovospalitel'nykh preparatov. Klinicheskie rekomendatsii. Nauchno-prakticheskaia revmatologiia. 2018; 56: 1–29. https://doi.org/10.14412/1995-4484-2018-1-29 [in Russian]
2. Makris UE, Abrams RC, Gurland B, Reid MC. Management of persistent pain in the older patient: a clinical review. JAMA 2014; 312 (8): 825–36. DOI: 10.1001/jama.2014.9405
3. Hunter TS, Robison C, Gerbino PP. Emerging evidence in NSAID pharmacology: important considerations for product selection. Am J Manag Care 2015; 21 (Suppl. 7): S139–47.
4. Xu S, Rouzer CA, Marnett LJ. Oxicams, a class of nonsteroidal anti-inflammatory drugs and beyond. IUBMB Life 2014; 66 (12): 803–11. DOI: 10.1002/iub.1334
5. Díaz-González F, Sánchez-Madrid F. NSAIDs: learning new tricks from old drugs. Eur J Immunol 2015; 45 (3): 679–86. DOI: 10.1002/eji.201445222
6. Vecchio AJ, Malkowski MG. The structural basis of endocannabinoid oxygenation by cyclooxygenase-2. J Biol Chem 2011; 286 (23): 20736–45. DOI: 10.1074/jbc.M111.230367
7. Vecchio AJ, Simmons DM, Malkowski MG. Structural basis of fatty acid substrate binding to cyclooxygenase-2. J Biol Chem 2010; 285 (29): 22152–63. DOI: 10.1074/jbc.M110.119867
8. Nilsen OG. Clinical pharmacokinetics of tenoxicam. Clin Pharmacokinet 1994; 26 (1): 16–43.
9. https://www.drugs.com/international/tenoxicam.html
10. http://www.ema.europa.eu/docs/en_GB/document_library/Periodic_safety_update_single_assessment/2016/1....
11. Lora M, Morisset S, Ménard HA et al. Expression of recombinant human cyclooxygenase isoenzymes in transfected COS-7 cells in vitro and inhibition by tenoxicam, indomethacin and aspirin. Prostaglandins Leukot Essent Fatty Acids 1997; 56 (5): 361–7.
12. Van Antwerpen P, Nève J. In vitro comparative assessment of the scavenging activity against three reactive oxygen species of non-steroidal anti-inflammatory drugs from the oxicam and sulfoanilide families. Eur J Pharmacol 2004; 496 (1–3): 55–61.
13. Ferrari GV, Natera J, Paulina Montaña M. Scavenging of photogenerated ROS by Oxicams. Possible biological and environmental implications. J Photochem Photobiol B 2015; 153: 233–9. DOI: 10.1016/j.jphotobiol.2015.09.024
14. Ozgocmen S, Ardicoglu O, Erdogan H et al. In vivo effect of celecoxib and tenoxicam on oxidant/anti-oxidant status of patients with knee osteoarthritis. Ann Clin Lab Sci 2005; 35 (2): 137–43.
15. Simpson J, Golding DN, Freeman AM et al. A large multicentre, parallel group, double-blind study comparing tenoxicam and piroxicam in the treatment of osteoarthritis and rheumatoid arthritis. Br J Clin Pract 1989; 43 (9): 328–33.
16. Moser U, Waldburger H, Schwarz HA, Gobelet CA. A double-blindrandomisedmulticentre study with tenoxicam, piroxicam and diclofenac sodium retard in the treatment of ambulant patients with osteoarthritis and extra-articular rheumatism. Scand J Rheumatol Suppl 1989; 80: 71–80.
17. Ejstrup L, Knudsen JV, Petersen L. A randomised double-blind multicentre trial comparing tenoxicam and ketoprofen in osteoarthritis. Scand J Rheumatol Suppl 1989; 80: 48–53.
18. Bellamy N, Buchanan WW, Chalmers A et al. A multicenter study of tenoxicam and diclofenac in patients with osteoarthritis of the knee. J Rheumatol 1993; 20 (6): 999–1004.
19. Riedemann PJ, Bersinic S, Cuddy LJ et al. A study to determine the efficacy and safety of tenoxicam versus piroxicam, diclofenac and indomethacin in patients with osteoarthritis: a meta-analysis. J Rheumatol 1993; 20 (12): 2095–103.
20. Langdon CG, Moran DG, Jamieson V et al. A multicentre study of tenoxicam for the treatment of osteo-arthritis and rheumatoid arthritis in general practice. J Int Med Res 1990; 18 (6): 489–96.
21. Kraag GR, Gordon DA, Ménard HA et al. Patient compliance with tenoxicam in family practice. Clin Ther 1994; 16 (3): 581–93.
22. Marcolongo R, Fioravanti A. Clinical experiences with tenoxicam. Preliminary results of a multicenter study. Recent Prog Med 1991; 82 (4): 242–9.
23. Ibrahima K, Kodjo G, Issa S et al. Clinical efficacy and tolerability of tenoxicam in African patients with osteoarthritis, rheumatoid arthritis, tendinitis and/or bursitis: an open study. Curr Med Res Opin 1991; 12 (7): 471–8.
24. Nived O, Sturfelt G, Eckernäs SA, Singer P. A comparison of 6 months' compliance of patients with rheumatoid arthritis treated with tenoxicam and naproxen. Use of patient computer data to assess response to treatment. J Rheumatol 1994; 21 (8): 1537–41.
25. Lund B, Andersen RB, Fossgreen J et al. A long-term randomised trial on tenoxicam and piroxicam in osteoarthritis of the hip or knee: a 24-month interim report focusing on the 12–24 month interval. Eur J Rheumatol Inflamm 1987; 9 (2): 58–67.
26. Lalos J, Tsachalos P, Gallis L. Long-term (four year) clinical trial with tenoxicam and basis therapy in patients suffering from rheumatoid arthritis. Scand J Rheumatol Suppl 1989; 80: 67–70.
27. Perez-Ruiz F, Alonso-Ruiz A, Ansoleaga JJ. Comparative study of the efficacy and safety of aceclofenac and tenoxicam in rheumatoid arthritis. Clin Rheumatol 1996; 15 (5): 473–7.
28. Villa Alcázar LF, de Buergo M, Rico Lenza H, Montull Fruitós E. Aceclofenac is as safe and effective as tenoxicam in the treatment of ankylosing spondylitis: a 3 month multicenter comparative trial. Spanish Study Group on Aceclofenac in Ankylosing Spondylitis. J Rheumatol 1996; 23 (7): 1194–9.
29. Valdés EF. Use of tenoxicam in patients with acute gouty arthritis. Eur J Rheumatol Inflamm 1987; 9 (2): 133–6.
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31. Van Durme CM, Wechalekar MD, Buchbinder R et al. Non-steroidal anti-inflammatory drugs for acute gout. Cochrane Database Syst Rev 2014; 9: CD010120. DOI: 10.1002/14651858.CD010120.pub2
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Авторы
А.Е.Каратеев
ФГБНУ «Научно-исследовательский институт ревматологии им. В.А.Насоновой». 115522, Россия, Москва, Каширское ш., д. 34А aekarat@yandex.ru
________________________________________________
A.E.Karateev
V.A.Nasonova Research Institute of Rheumatology. 115522, Russian Federation, Moscow, Kashirskoe sh., d. 34A aekarat@yandex.ru