Literature DB >> 11511027

Aceclofenac: a reappraisal of its use in the management of pain and rheumatic disease.

M Dooley1, C M Spencer, C J Dunn.   

Abstract

UNLABELLED: Aceclofenac is an orally administered phenylacetic acid derivative with effects on a variety of inflammatory mediators. Through its analgesic and anti-inflammatory properties, aceclofenac provides symptomatic relief in a variety of painful conditions. In patients with osteoarthritis of the knee, the drug decreases pain, reduces disease severity and improves the functional capacity of the knee to a similar extent to diclofenac, piroxicam and naproxen. Aceclofenac reduces joint inflammation, pain intensity and the duration of morning stiffness in patients with rheumatoid arthritis, and is similar in efficacy to ketoprofen, diclofenac, indomethacin and tenoxicam in these patients. The duration of morning stiffness and pain intensity are reduced, and spinal mobility improved, by aceclofenac in patients with ankylosing spondylitis, with improvements being similar to those observed with indomethacin, naproxen or tenoxicam. Aceclofenac is also effective in other painful conditions (e.g. dental and gynaecological). In contrast to some other NSAIDs, aceclofenac has shown stimulatory effects on cartilage matrix synthesis. Aceclofenac is well tolerated, with most adverse events being minor and reversible, and affecting mainly the GI system. Although the incidence of GI adverse events with aceclofenac was similar to those of comparator NSAIDs in individual clinical trials, withdrawal rates due to these events were significantly lower with aceclofenac than with ketoprofen and tenoxicam. Superior overall and/or GI tolerability of the drug relative to other NSAIDs has been indicated by a nonrandomised comparison with sustained release diclofenac in 10,142 patients, a meta-analysis of 13 comparisons with diclofenac, naproxen, piroxicam, indomethacin, tenoxicam or ketoprofen in 3574 patients, and preliminary details of a comparison with 10 other NSAIDs in 142,776 patients. Further analysis of the above meta-analytical data has indicated that costs incurred as a result of adverse event management are lower with aceclofenac than with a range of comparator NSAIDs.
CONCLUSIONS: Trials of 2 to 6 months' duration have shown aceclofenac to be an effective agent in the management of pain and rheumatic disease. Data from in vitro studies indicate properties of particular interest with respect to cartilage matrix effects and selectivity for cyclo-oxygenase-2. Aceclofenac is well tolerated, with encouraging reports of improved general and GI tolerability relative to other NSAIDs from a meta-analysis of double-blind trials and from large nonblind studies.

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Year:  2001        PMID: 11511027     DOI: 10.2165/00003495-200161090-00012

Source DB:  PubMed          Journal:  Drugs        ISSN: 0012-6667            Impact factor:   9.546


  34 in total

1.  COX-1-sparing NSAIDs--is the enthusiasm justified?

Authors:  W L Peterson; B Cryer
Journal:  JAMA       Date:  1999-11-24       Impact factor: 56.272

2.  Aceclofenac blocks prostaglandin E2 production following its intracellular conversion into cyclooxygenase inhibitors.

Authors:  R Yamazaki; S Kawai; T Matsuzaki; N Kaneda; S Hashimoto; T Yokokura; R Okamoto; T Koshino; Y Mizushima
Journal:  Eur J Pharmacol       Date:  1997-06-25       Impact factor: 4.432

3.  Hypersensitivity vasculitis related to aceclofenac.

Authors:  R Morros; A Figueras; D Capella; J R Laporte
Journal:  Br J Rheumatol       Date:  1997-04

4.  A major metabolite of aceclofenac, 4'-hydroxy aceclofenac, suppresses the production of interstitial pro-collagenase/proMMP-1 and pro-stromelysin-1/proMMP-3 by human rheumatoid synovial cells.

Authors:  R Yamazaki; S Kawai; Y Mizushima; T Matsuzaki; S Hashimoto; T Yokokura; A Ito
Journal:  Inflamm Res       Date:  2000-03       Impact factor: 4.575

5.  Hydrolytic activity is essential for aceclofenac to inhibit cyclooxygenase in rheumatoid synovial cells.

Authors:  R Yamazaki; S Kawai; T Matsumoto; T Matsuzaki; S Hashimoto; T Yokokura; R Okamoto; T Koshino; Y Mizushima
Journal:  J Pharmacol Exp Ther       Date:  1999-05       Impact factor: 4.030

Review 6.  Management of osteoarthritis in the primary-care setting: an evidence-based approach to treatment.

Authors:  N E Lane; J M Thompson
Journal:  Am J Med       Date:  1997-12-29       Impact factor: 4.965

7.  Metabolism of aceclofenac in humans.

Authors:  R Bort; X Ponsoda; E Carrasco; M J Gómez-Lechón; J V Castell
Journal:  Drug Metab Dispos       Date:  1996-08       Impact factor: 3.922

8.  Evaluation of the analgesic activity and tolerability of aceclofenac in the treatment of post-episiotomy pain.

Authors:  P G Movilia
Journal:  Drugs Exp Clin Res       Date:  1989

9.  The efficacy and tolerability of aceclofenac in the treatment of patients with ankylosing spondylitis: a multicenter controlled clinical trial. Aceclofenac Indomethacin Study Group.

Authors:  E Batlle-Gualda; M Figueroa; J Ivorra; A Raber
Journal:  J Rheumatol       Date:  1996-07       Impact factor: 4.666

10.  Pharmacology of the potent new non-steroidal anti-inflammatory agent aceclofenac.

Authors:  M Grau; J Guasch; J L Montero; A Felipe; E Carrasco; S Juliá
Journal:  Arzneimittelforschung       Date:  1991-12
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  15 in total

1.  Pharmacokinetics of a new once-daily controlled-release formulation of aceclofenac in Korean healthy subjects compared with immediate-release aceclofenac and the effect of food: a randomized, open-label, three-period, crossover, single-centre study.

Authors:  Soo Kyung Bae; Soo-Hwan Kim; Hae Won Lee; Sook Jin Seong; Su-Yeon Shin; Sang Hun Lee; Mi-Sun Lim; Young-Ran Yoon; Hye Jung Lee
Journal:  Clin Drug Investig       Date:  2012-02-01       Impact factor: 2.859

2.  Enhancement of ocular efficacy of aceclofenac using biodegradable PLGA nanoparticles: formulation and characterization.

Authors:  Rajesh Katara; Sameer Sachdeva; Dipak K Majumdar
Journal:  Drug Deliv Transl Res       Date:  2017-10       Impact factor: 4.617

3.  Efficacy and safety of aceclofenac in osteoarthritis: A meta-analysis of randomized controlled trials.

Authors:  Parvati B Patel; Tejas K Patel
Journal:  Eur J Rheumatol       Date:  2017-03-01

4.  Effects of ibuprofen on molecular markers of cartilage and synovium turnover in patients with knee osteoarthritis.

Authors:  E Gineyts; J A Mo; A Ko; D B Henriksen; S P Curtis; B J Gertz; P Garnero; P D Delmas
Journal:  Ann Rheum Dis       Date:  2004-07       Impact factor: 19.103

5.  Aceclofenac-tizanidine in the treatment of acute low back pain: a double-blind, double-dummy, randomized, multicentric, comparative study against aceclofenac alone.

Authors:  Anil Pareek; Nitin Chandurkar; A S Chandanwale; Ratnakar Ambade; Anil Gupta; Girish Bartakke
Journal:  Eur Spine J       Date:  2009-05-07       Impact factor: 3.134

6.  Long term NSAID treatment inhibits COX-2 synthesis in the knee synovial membrane of patients with osteoarthritis: differential proinflammatory cytokine profile between celecoxib and aceclofenac.

Authors:  M A Alvarez-Soria; R Largo; J Santillana; O Sánchez-Pernaute; E Calvo; M Hernández; J Egido; G Herrero-Beaumont
Journal:  Ann Rheum Dis       Date:  2006-02-13       Impact factor: 19.103

7.  Application of HPLC for the simultaneous determination of aceclofenac, paracetamol and tramadol hydrochloride in pharmaceutical dosage form.

Authors:  Preeti Chandra; Atul Singh Rathore; Sathiyanarayanan Lohidasan; Kakasaheb Ramoo Mahadik
Journal:  Sci Pharm       Date:  2012-01-31

8.  Efficacy and Safety of Aceclofenac Controlled Release in Patients with Knee Osteoarthritis: A 4-week, Multicenter, Randomized, Comparative Clinical Study.

Authors:  Young-Wan Moon; Seung-Baik Kang; Tae-Kyun Kim; Myung-Chul Lee
Journal:  Knee Surg Relat Res       Date:  2014-02-27

9.  Efficacy of aceclofenac and diclofenac sodium for relief of postoperative pain after third molar surgery: A randomised open label comparative study.

Authors:  Nagendra S Chunduri; Tanveer Kollu; Venkateswarulu R Goteki; Kiran K Mallela; Krishnaveni Madasu
Journal:  J Pharmacol Pharmacother       Date:  2013-04

Review 10.  The future of osteoarthritis therapeutics: targeted pharmacological therapy.

Authors:  A Mobasheri
Journal:  Curr Rheumatol Rep       Date:  2013-10       Impact factor: 4.592

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