Opçöes para a utilizaçåo dos antiinflamatórios nåo-esteróides no manejo da psoríase artropática / The management of arthropatic psoriasis with nonsteroidal antiinflammatory

Os antiinflamatórios nåo-esteróides såo fármacos nåo-esteroidais que inibem a via da ciclooxigenase no metabolismo do ácido aracdônio, suprimindo a síntese das prostaglandinas. Algumas destas drogas exacerbam as lesöes cutâneas da psoríase (indometacina, ácido acetilsalicílico). Outros antiinflamatórios nåo-esteróides apresentam uma boa açåo farmacológica sem exacerbarem o quadro dermatológico da moléstia (naproxeno, ibuprofeno e fenilbutazona). Estas drogas proporcionaråo novas opçöes na terapêutica da psoríase artropática. Os autores relatam sua experiência no manejo da psoríase artropática com os antiinflamatórios nåo-esteróides

Drug-triggered pemphigus in a predisposed woman.

A 31-year-old woman with three pemphigus-prone antigens in her HLA haplotype (B7, DR4, DQw7) developed the disease soon after taking a pyrazolone derivative, viz. feprazone. The pemphigus lesions persisted despite withdrawal of the drug and worsened appreciably when she used ceftriaxone (a new cephalosporin with three sulphur atoms) for a bout of acute pharyngitis. Thiol groups formed from the metabolic breakdown of ceftriaxone are thought to have promoted acantholysis via a biochemical route. Genetic predisposition alone ('the soil') may be essential, though not per se sufficient for outbreak of pemphigus; the intervention of exogenous, heterogeneous factors ('the seed') often seems decisive in triggering full-blown disease.

[Pharmacological and clinical profile of tiaprofenic acid]. / Profilo farmacologico e clinico dell'acido tiaprofenico.

Tiaprofenic acid is a new generation anti-inflammatory drug synthesized to be a valid alternative to both cortisone preparations and other NSADs since it is less toxic yet equally effective. Its anti-inflammatory, analgesic, antipyretic activity is due to a particular interference mechanism active in the early phases of the inflammatory process (PG synthesis inhibition, stabilization of lysosomal membranes). Thanks to its good trophism toward tissues in the otolaryngological area and its tolerability this drug would appear particularly suited for the treatment of inflammatory E.N.T. pathologies.

[Use of nimesulide in inflammations of the upper respiratory tract]. / Impiego della nimesulide nelle flogosi delle vie respiratorie superiori.

In a controlled clinical study of 40 patients, aged 18 to 65, suffering from acute inflammatory pathology of the upper respiratory tract or from a chronic form flaring into acute crisis, without any general symptoms of infection, were assigned at random to treatment with nimesulide in tablet form (100 mg x 2/day), or with phenylprenazone in capsules (200 mg x 2/day) for a period of seven days. In both groups a clinically significant reduction of the symptoms was obtained (congestion and edema of the pharyngeal mucosa, cough) as well as an improvement in the values of conductance and MCTt. Epigastralgy was evidenced in three subjects treated with nimesulide and in four treated with phenylprenazone. No significant variations of the laboratory parameters were found in either treatment group.

Emprego clínico da feprazona em odontologia / Clinical use of feprazone in dentistry

Os autores trataram 35 pacientes em intervençoes odontológicas diversas. Estes casos foram divididos em três grupos, de acordo com as entidades clínicas tratadas. O grupo I incluiu 12 pacientes, nos quais foram realizados tratamentos endodônticos, sendo que em 2, simultaneamente, foram realizadas cirurgias (curetagem de bolsas periodontais e extraçoes múltiplas). O grupo II incluiu 9 pacientes, que foram submetidos a cirurgias bucais menores, tais como extraçoes múltiplas, epicetomias e devido a problemas periodontais. O grupo III era constituído por 12 pacientes de ambos os sexos, submetidos a cirurgias mais extensas. Sua idade variou entre 7 e 60 anos. A todos os pacientes foi administrada a feprazona, na dose de 1 cápsula de 12 em 12 horas, durante quatro dias. Efeitos colaterais surgiram em dois casos; foi necessário suspender o medicamento em apenas um paciente, que apresentou erupçao cutânea

The use of thermography in the evaluation of the anti-inflammatory activity of feprazone on rheumatoid arthritis.

By means of the exploration of patients suffering from an active, unequivocal rheumatoid arthritis it was possible to show the unequivocal, and antiinflammatory effect of 4-phenyl-1,2-diphenyl-3,5-pyrazolidinedione (feprazone, Zepelin). Moreover, it was documented that thermography is a very suitable medium to furnish proof of this effect and can be used to the advantage of the patients in clinical routine. The physiological processes of the production and distribution of heat must be taken into account to avoid false interpretation of thermograms.

[Results of an open study and a controlled comparative study of feprazone and naproxen in patients with rheumatoid arthritis or osteoarthrosis (author's transl)]. / Ergebnisse einer einfach offenen sowie einer kontrollierten Vergleichesstudie mit Feprazon und Naproxen bei Polyarthritis- und Osteoarthrose-Patienten.

The so-called non-steroid antirheumatics have considerable significance in medical armamentarium for controlling polyetiological complexes of diseases. The numerous new developments are designed to reduce the side effects, some of which seem inevitable with increased efficacy. In this two-part study the authors deal with the new Feprazone. Prior to a double-blind randomized comparative study against Naproxen, an open study on effect and tolerance was performed in ten rheumatic patients over three months. In the second part a controlled study was carried out in 30 patients for four weeks following this treatment. The patients half of whom were each given 600 mg Feprazone or 750 mg Naproxen showed a definite improvement in the rheumatic symptoms as compared with their initial situation. A difference in therapeutic efficacy and tolerance was only noticeable in a slight trend in favour of Feprazone.

Miscellaneous rheumatological conditions treated in monitored-release studies with feprazone.

In two monitored-release studies of feprazone (Methrazone), one in hospital and the other in general practice and involving a total of about 4,000 patients, there were 343 patients with a variety of sero-negative rheumatological conditions or soft tissue lesions. The diagnoses included spondylosis, ankylosing spondylitis, psoriatic arthritis, capsulitis, frozen shoulder, polymyalgia rheumatica and gout. Most of the patients were classified as moderately or severely affected. Feprazone in a dose of 200 mg thrice daily appeared to benefit about 60% of patients during a course of 8 weeks of therapy. No serious adverse reactions directly attributable to the drug were recorded. About 20% of patients stopped treatment because of side-effects, usually gastro-intestinal disturbance or rash. Two patients experienced a marked fall in platelet count which might have been due to the drug, but neither developed any signs of thrombocytopenic purpura.

Safety and efficacy of feprazone for long-term treatment of rheumatoid arthritis and osteoarthritis.

Long-term safety and efficacy of feprazone (4-prenyl-1,2-diphenyl-3,5-pyrazolidinedione), an antirheumatic drug that is well tolerated in the gastrointestinal tract, were assessed in a noncontrolled multicenter trial. Administered at a daily dosage of 600 mg for a mean duration of 114.1 days, feprazone was well tolerated by 43 (77%) of 56 treated subjects. Thirteen patients reported side effects, but only five discontinued treatment. The side effects were generally mild and occurred in the first weeks of therapy. Feprazone was found effective after one month on both considered indices of disease activity: Ritchie index (articular index for assessment of joint tenderness) and corticosteroid consumption.

Double-blind trial of feprazone and phenylbutazone in acute gout.

A double-blind trial was carried out in 24 patients with acute gout to compare the efficacy and tolerance of feprazone, a non-steroidal anti-inflammatory drug, with that of phenylbutazone. Patients received 800 mg of either drug daily for 2 days and then 600 mg daily for up to 8 days. The results of patient assessment showed there was no significant difference between the two groups in time taken either to significant improvement or to final resolution of the gout attack. No side-effects were reported with either drug.

A monitored-release study of methrazone in general practice.

Methrazone, a non-steroidal anti-inflammatory drug, was used on a monitored release study in general practice to treat 2,693 patients with rheumatoid or osteoarthritis. In a dose of 200 mg three times daily, it appeared to produce clear benefit in between 50% and 60% of patients. Adverse reactions such as dyspepsia and skin rash led to the drug being withdrawn in 11% of patients. There were three major adverse reactions possibly due to the drug (haematemesis, rectal bleeding and acute purpura), but no cases of severe leucopenia or thrombocytopenia. Methrazone is a useful anti-inflammatory agent. In particular, it is unlikely to cause interactions with other drugs, including cardiac glycosides such as digoxin.