Looking for:
[Steroid saving effect of naproxen] |
Prednisone naproxen -
Since for various reasons the Lansbury Index appeared inadequate to define the therapeutic efficacy of antirheumatic compounds, we chose to investigate in our trials the prednisolone saving effect in patients with rheumatoid arthritis. In cases where a daily dose of 10 mg of prednisolone was necessary, a saving of 7.
But there were also failures and lesser saving effects. The steroid saving effect differs from one individual to another. In an additional study naproxen in a daily dose of mg was compared with other antirheumatic agents indometacin, azapropazon, and nifluminic acid in patients not requiring steroids. The results were not uniform. In some cases naproxen was more effective, in other cases the substances mentioned were better. In these series joint function and subjective changes only were evaluated.
Apart from a few cases of gastrointestinal side effects the drug was well tolerated. Abstract Since for various reasons the Lansbury Index appeared inadequate to define the therapeutic efficacy of antirheumatic compounds, we chose to investigate in our trials the prednisolone saving effect in patients with rheumatoid arthritis.
Publication types Comparative Study English Abstract.
❿- Oral Prednisolone and Naproxen (Aleve) Equal for Gout Pain | MedPage Today
The steroid saving effect differs from one individual to another. In an additional study naproxen in a daily dose of mg was compared with other antirheumatic agents indometacin, azapropazon, and nifluminic acid in patients not requiring steroids. The results were not uniform. Primary-care patients with gout confirmed by presence of monosodium urate crystals were eligible.
Treatment was masked for both patients and physicians. Analyses were done per protocol and by intention to treat. Findings: Data were incomplete for one patient in each treatment group, so per-protocol analyses included 59 patients in each group. Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines.
Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully. Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of prednisone in children.
However, pediatric patients are more likely to have slower growth and bone problems if prednisone is used for a long time. Recommended doses should not be exceeded, and the patient should be carefully monitored during therapy.
Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of prednisone in the elderly. However, elderly patients are more likely to have age-related liver, kidney, or heart problems, which may require caution and an adjustment in the dose for elderly patients receiving prednisone.
There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding. Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur.
In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive. Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines. Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you.
Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco. The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:.
Take this medicine exactly as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. To do so may increase the chance for unwanted effects. Measure the oral liquid with a marked measuring spoon, oral syringe, or medicine cup. The average household teaspoon may not hold the right amount of liquid.
Measure the concentrated liquid with the special oral dropper that comes with the package. If you use this medicine for a long time, do not suddenly stop using it without checking first with your doctor. You may need to slowly decrease your dose before stopping it completely. The dose of this medicine will be different for different patients.
❾-50%}-
Using this medicine while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using this medicine, tell your doctor right away. If you are using this medicine for a long time, tell your doctor about any extra stress or anxiety in your life, including other health concerns and emotional stress.
Your dose of this medicine might need to be changed for a short time while you have extra stress. Using too much of this medicine or using it for a long time may increase your risk of having adrenal gland problems. Talk to your doctor right away if you have more than one of these symptoms while you are using this medicine: blurred vision, dizziness or fainting, a fast, irregular, or pounding heartbeat, increased thirst or urination, irritability, or unusual tiredness or weakness.
This medicine may cause you to get more infections than usual. Avoid people who are sick or have infections and wash your hands often. If you are exposed to chickenpox or measles, tell your doctor right away.
If you start to have a fever, chills, sore throat, or any other sign of an infection, call your doctor right away. Check with your doctor right away if blurred vision, difficulty in reading, eye pain, or any other change in vision occurs during or after treatment. Your doctor may want you to have your eyes checked by an ophthalmologist eye doctor.
While you are being treated with prednisone, do not have any immunizations vaccines without your doctor's approval. Prednisone may lower your body's resistance and the vaccine may not work as well or you might get the infection the vaccine is meant to prevent. In addition, you should not be around other persons living in your household who receive live virus vaccines because there is a chance they could pass the virus on to you. Some examples of live vaccines include measles, mumps, influenza nasal flu vaccine , poliovirus oral form , rotavirus, and rubella.
Do not get close to them and do not stay in the same room with them for very long. If you have questions about this, talk to your doctor. This medicine may cause changes in mood or behavior for some patients. Tell your doctor right away if you have depression, mood swings, a false or unusual sense of well-being, trouble with sleeping, or personality changes while taking this medicine. This medicine might cause thinning of the bones osteoporosis or slow growth in children if used for a long time.
Tell your doctor if you have any bone pain or if you have an increased risk for osteoporosis. If your child is using this medicine, tell the doctor if you think your child is not growing properly. Make sure any doctor or dentist who treats you knows that you are using this medicine. This medicine may affect the results of certain skin tests. Do not take other medicines unless they have been discussed with your doctor.
This includes prescription or nonprescription over-the-counter [OTC] medicines and herbal or vitamin supplements. Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention. Some side effects may occur that usually do not need medical attention.
These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Rainer, M. First, they said, although well-designed, the study was fairly small and was done at one center.
It needs to be repeated in other locales with different rates of gastrointestinal disease. Second, they said, changes in clinical practice often need strong marketing forces, which might not occur unless drug companies stand to benefit from newer more expensive drugs. Nevertheless, they concluded, this trial "will go some way to satisfy both rheumatological purists and front-line pragmatists that short-term oral corticosteroids are as equally effective as NSAIDs in the initial treatment of acute gout and gout-like syndrome.
Source Reference: Janssens H, et al "Use of oral prednisolone or naproxen for the treatment of gout arthritis: a double-blind, randomised equivalence trial" The Lancet ; Share on Facebook.
Opens in a new tab or window. Share on Twitter. Share on LinkedIn. Explain that the study was fairly small and needs to be repeated in larger, broader studies if clinical practice is to change. In cases where a daily dose of 10 mg of prednisolone was necessary, a saving of 7. But there were also failures and lesser saving effects. The steroid saving effect differs from one individual to another.
Background: Non-steroidal anti-inflammatory drugs and colchicine used to treat gout arthritis have gastrointestinal, renal, and cardiovascular adverse effects. Systemic corticosteroids might be a beneficial alternative.
We investigated equivalence of naproxen and prednisolone in primary care. Methods: We did a randomised clinical trial to test equivalence of prednisolone and naproxen for the treatment of monoarticular gout.
Primary-care patients with gout confirmed by presence of monosodium urate crystals were eligible. Treatment was masked for both patients and physicians. Analyses were done per protocol and by intention to treat. Findings: Data were incomplete for one patient in each treatment group, so per-protocol analyses included 59 patients in each group. After 90 h the reduction in the pain score was The difference in the size of change in pain was 1.
Adverse effects were similar between groups, minor, and resolved by 3 week follow-up. Interpretation: Oral prednisolone and naproxen are equally effective in the initial treatment of gout arthritis over 4 days.
Abstract Background: Non-steroidal anti-inflammatory drugs and colchicine used to treat gout arthritis have gastrointestinal, renal, and cardiovascular adverse effects.
Compare Naproxen vs Prednisone head-to-head with other drugs for uses, ratings, cost, side effects and interactions. How the interaction occurs: When these two medicines are taken together, they may increase. NIJMEGEN, The Netherlands, May 29 -- For the acute pain of monoarticular gout over four days, it's a tossup between oral prednisolone and. Both oral prednisolone 35 mg once a day and naproxen mg twice a day seemed effective in the treatment of gout arthritis. The 95% CI for the. Prednisone is a corticosteroid (cortisone-like medicine or steroid). Nadifloxacin; Nadroparin; Naproxen; Nepafenac; Nifedipine; Niflumic Acid. Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of prednisone in children. Prednisone provides relief for inflamed areas of the body. Nevertheless, they concluded, this trial "will go some way to satisfy both rheumatological purists and front-line pragmatists that short-term oral corticosteroids are as equally effective as NSAIDs in the initial treatment of acute gout and gout-like syndrome. However, pediatric patients are more likely to have slower growth and bone problems if prednisone is used for a long time.In an equivalence study, pain scores for the corticosteroid and NSAID were similar as were the number of adverse events, which were minor, Hein Janssens, M. Action Points If patients ask, explain that prednisolone, a corticosteroid, was as effective as the commonly used nonsteroidal anti-inflammatory drug naproxen Aleve in relieving the pain of a gout attack. Yet for gastrointestinal-bleeding reasons, the authors said, the study provides a strong argument to consider prednisolone as a first treatment option over NSAIDs for patients with gout.
Use of cochicine has declined because of its disadvantage in renal failure and NSAIDS have been associated with gastrointestinal and cardiovascular risks often seen in gout patients. Prednisolone may also turn out to be less costly because they don't require gastroprotective drugs added to treatment with NSAIDs, the researchers said.
The researchers undertook a randomized clinical trial to test the equivalence of naproxen and prednisolone for treating monoarticular gout. From March 24, through July 14, , family physicians in the eastern part of Holland were asked to send all patients with monoarthritis to the trial center, even if gout was not the most likely diagnosis. Treatment was masked for both patients and physicians. Data were incomplete for one patient in each treatment group, so analyses included 59 patients in each group.
After 90 hours, the reduction in the pain score was The difference in the size of change in the pain score for the whole observation period intervals was 1.
Reductions in the pain scores were equivalent and went from 62 mm to 17 mm for prednisolone and 59 mm to 13 mm for naproxen, in a similar pattern. For general disability, the differences were 0. In all cases these differences non-significantly favored naproxen, the investigators said. Adverse effects were similar and minor between groups, and resolved by the three-week follow-up.
After three weeks, all patients reported, by telephone, complete relief of signs and symptoms, and no patients reported a recurrent attack. Study limitations included assessment of complete relief based on self-reporting, the use of non-validated scales to assess disability outcomes, and a study population limited to white Dutch people.
Although no patients were excluded in this study because of the risks from prednisolone treatment, a quarter of originally eligible patients had to be excluded because of direct safety risks had they been treated with naproxen. For these patients, a five-day treatment with prednisolone would have been no problem, the researchers said. In addition to better safety, they wrote, the direct drug costs would also be less if systemic corticosteroids, such as prednisolone, were the first-line drug choice.
In an accompanying comment, Timothy H. Rainer, M. First, they said, although well-designed, the study was fairly small and was done at one center. It needs to be repeated in other locales with different rates of gastrointestinal disease.
Second, they said, changes in clinical practice often need strong marketing forces, which might not occur unless drug companies stand to benefit from newer more expensive drugs. Nevertheless, they concluded, this trial "will go some way to satisfy both rheumatological purists and front-line pragmatists that short-term oral corticosteroids are as equally effective as NSAIDs in the initial treatment of acute gout and gout-like syndrome.
Source Reference: Janssens H, et al "Use of oral prednisolone or naproxen for the treatment of gout arthritis: a double-blind, randomised equivalence trial" The Lancet ; Share on Facebook.
Opens in a new tab or window. Share on Twitter. Share on LinkedIn. Explain that the study was fairly small and needs to be repeated in larger, broader studies if clinical practice is to change.
Point out that for gastrointestinal-bleeding reasons, the authors said, the study provides a strong argument to consider prednisolone as a first treatment option over NSAIDs for patients with gout. Primary Source The Lancet Source Reference: Janssens H, et al "Use of oral prednisolone or naproxen for the treatment of gout arthritis: a double-blind, randomised equivalence trial" The Lancet ; The researchers and the editorial writers declared no conflict of interest.
No comments:
Post a Comment