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Wang RD, Sheng XR, Guan WX, Wang M, Peng C, Yang YY, Huang HG, Ning-Li, Jia WD. Flurbiprofen axetil for postoperative analgesia in upper abdominal surgery: a randomized, parallel controlled, double-blind, multicenter clinical study. Surg Today 2020; 50:749-756. [PMID: 31925579 DOI: 10.1007/s00595-019-01951-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 12/14/2019] [Indexed: 12/14/2022]
Abstract
PURPOSE To investigate the efficacy and safety of flurbiprofen axetil in postoperative analgesia in upper abdominal surgery. METHODS This was a multicenter, randomized, positive drug parallel controlled double-blind clinical study. Patients undergoing upper abdominal surgery were randomly divided to receive flurbiprofen axetil or tramadol. The VAS pain scores at rest and on coughing (pulmonary function training) were assessed immediately before drug usage (T1) to evaluate the efficacy of postoperative analgesia. Repeat assessment of the VAS was performed after T1. The timing of the recovery of the gastrointestinal function and the preoperative and postoperative IL-6, cortisol, and blood glucose levels were recorded as secondary endpoints. Vital signs and the occurrence of adverse reactions were evaluated for the assessment of safety. RESULTS A total of 240 patients were enrolled in the current study; 119 used flurbiprofen axetil for postoperative analgesia. The VAS scores at rest and on coughing did not differ between the two groups to a statistically significant extent (P > 0.05). However, the reduction of the VAS score at rest in the flurbiprofen axetil group was greater than that in the tramadol group at 4-24 h after T1. The reduction of the VAS score on coughing at 8 h after T1 was greater in the flurbiprofen axetil group. The incidence of adverse reactions was significantly lower in the flurbiprofen axetil group, with only one adverse reaction recorded. In contrast, 18 adverse reactions were reported in the tramadol group. CONCLUSION Flurbiprofen axetil showed superior efficacy to tramadol in early postoperative analgesia after upper abdominal surgery. Flurbiprofen axetil was associated with a significantly lower incidence of adverse reactions in comparison to tramadol.
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Affiliation(s)
- Run-Dong Wang
- Department of General Surgery, Anhui No. 2 Provincial People's Hospital, Hefei, Anhui, People's Republic of China.,Department of Liver Surgery, The First Affiliated Hospital of USTC, 17 Lujiang Road, Luyang, Hefei, Anhui, 230001, People's Republic of China.,Anhui Province Key Laboratory of Hepatopancreatobiliary Surgery, Hefei, People's Republic of China
| | - Xu-Ren Sheng
- Department of Liver Surgery, The First Affiliated Hospital of USTC, 17 Lujiang Road, Luyang, Hefei, Anhui, 230001, People's Republic of China.,Anhui Province Key Laboratory of Hepatopancreatobiliary Surgery, Hefei, People's Republic of China
| | - Wen-Xian Guan
- Department of General Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, People's Republic of China
| | - Meng Wang
- Department of General Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, People's Republic of China
| | - Chuang Peng
- Hepatological Surgery Department, Hunan Provincial People's Hospital, The First Hospital Affiliated with Hunan Normal University, Changsha, People's Republic of China
| | - Yuan-Yuan Yang
- The Basic Surgical, Union Hospital Affiliated with Fujian Medical University, Fuzhou, People's Republic of China
| | - He-Guang Huang
- The Basic Surgical, Union Hospital Affiliated with Fujian Medical University, Fuzhou, People's Republic of China
| | - Ning-Li
- Intestinal Microenvironment Treatment Center, Tenth People's Hospital of Tongji University, Shanghai, People's Republic of China
| | - Wei-Dong Jia
- Department of Liver Surgery, The First Affiliated Hospital of USTC, 17 Lujiang Road, Luyang, Hefei, Anhui, 230001, People's Republic of China. .,Anhui Province Key Laboratory of Hepatopancreatobiliary Surgery, Hefei, People's Republic of China.
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Wobst I, Ebert L, Birod K, Wegner MS, Hoffmann M, Thomas D, Angioni C, Parnham MJ, Steinhilber D, Tegeder I, Geisslinger G, Grösch S. R-Flurbiprofen Traps Prostaglandins within Cells by Inhibition of Multidrug Resistance-Associated Protein-4. Int J Mol Sci 2016; 18:ijms18010068. [PMID: 28042832 PMCID: PMC5297703 DOI: 10.3390/ijms18010068] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Revised: 12/22/2016] [Accepted: 12/23/2016] [Indexed: 02/06/2023] Open
Abstract
R-flurbiprofen is the non-COX-inhibiting enantiomer of flurbiprofen and is not converted to S-flurbiprofen in human cells. Nevertheless, it reduces extracellular prostaglandin E2 (PGE2) in cancer or immune cell cultures and human extracellular fluid. Here, we show that R-flurbiprofen acts through a dual mechanism: (i) it inhibits the translocation of cPLA2α to the plasma membrane and thereby curtails the availability of arachidonic acid and (ii) R-flurbiprofen traps PGE2 inside of the cells by inhibiting multidrug resistance–associated protein 4 (MRP4, ABCC4), which acts as an outward transporter for prostaglandins. Consequently, the effects of R-flurbiprofen were mimicked by RNAi-mediated knockdown of MRP4. Our data show a novel mechanism by which R-flurbiprofen reduces extracellular PGs at physiological concentrations, particularly in cancers with high levels of MRP4, but the mechanism may also contribute to its anti-inflammatory and immune-modulating properties and suggests that it reduces PGs in a site- and context-dependent manner.
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Affiliation(s)
- Ivonne Wobst
- Pharmazentrum frankfurt, ZAFES, Institute for Clinical Pharmacology, Goethe-University Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt/Main, Germany; (I.W.); (K.B.); (M.-S.W.); (D.T.); (C.A.); (I.T.); (G.G.)
| | - Lisa Ebert
- Fraunhofer Institute for Molecular Biology and Applied Ecology IME, Project Group Translational Medicine and Pharmacology TMP, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany; (L.E.); (M.J.P.)
| | - Kerstin Birod
- Pharmazentrum frankfurt, ZAFES, Institute for Clinical Pharmacology, Goethe-University Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt/Main, Germany; (I.W.); (K.B.); (M.-S.W.); (D.T.); (C.A.); (I.T.); (G.G.)
| | - Marthe-Susanna Wegner
- Pharmazentrum frankfurt, ZAFES, Institute for Clinical Pharmacology, Goethe-University Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt/Main, Germany; (I.W.); (K.B.); (M.-S.W.); (D.T.); (C.A.); (I.T.); (G.G.)
| | - Marika Hoffmann
- Institute of Pharmaceutical Chemistry, ZAFES, Johann Wolfgang Goethe-University Frankfurt, Max-von-Laue-Str. 9, D-60438 Frankfurt, Germany;
| | - Dominique Thomas
- Pharmazentrum frankfurt, ZAFES, Institute for Clinical Pharmacology, Goethe-University Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt/Main, Germany; (I.W.); (K.B.); (M.-S.W.); (D.T.); (C.A.); (I.T.); (G.G.)
| | - Carlo Angioni
- Pharmazentrum frankfurt, ZAFES, Institute for Clinical Pharmacology, Goethe-University Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt/Main, Germany; (I.W.); (K.B.); (M.-S.W.); (D.T.); (C.A.); (I.T.); (G.G.)
| | - Michael J. Parnham
- Fraunhofer Institute for Molecular Biology and Applied Ecology IME, Project Group Translational Medicine and Pharmacology TMP, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany; (L.E.); (M.J.P.)
| | - Dieter Steinhilber
- Institute of Pharmaceutical Chemistry, ZAFES, Johann Wolfgang Goethe-University Frankfurt, Max-von-Laue-Str. 9, D-60438 Frankfurt, Germany;
| | - Irmgard Tegeder
- Pharmazentrum frankfurt, ZAFES, Institute for Clinical Pharmacology, Goethe-University Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt/Main, Germany; (I.W.); (K.B.); (M.-S.W.); (D.T.); (C.A.); (I.T.); (G.G.)
| | - Gerd Geisslinger
- Pharmazentrum frankfurt, ZAFES, Institute for Clinical Pharmacology, Goethe-University Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt/Main, Germany; (I.W.); (K.B.); (M.-S.W.); (D.T.); (C.A.); (I.T.); (G.G.)
- Fraunhofer Institute for Molecular Biology and Applied Ecology IME, Project Group Translational Medicine and Pharmacology TMP, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany; (L.E.); (M.J.P.)
| | - Sabine Grösch
- Pharmazentrum frankfurt, ZAFES, Institute for Clinical Pharmacology, Goethe-University Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt/Main, Germany; (I.W.); (K.B.); (M.-S.W.); (D.T.); (C.A.); (I.T.); (G.G.)
- Correspondence: ; Tel.: +49/69-6301-7820; Fax: +49/69-6301-7636
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Hu J, Lan T, Sun Y, Chen H, Yao J, Rao Y. Unactivated C(sp(3))-H hydroxylation through palladium catalysis with H2O as the oxygen source. Chem Commun (Camb) 2016; 51:14929-32. [PMID: 26307027 DOI: 10.1039/c5cc04952k] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
A novel palladium catalyzed hydroxylation of unactivated aliphatic C(sp(3))-H bonds was successfully developed. Different from conventional methods, water serves as the hydroxyl group source in the reaction. This new reaction demonstrates good reactivity and broad functional group tolerance. The C-H hydroxylated products can be readily transformed into various highly valuable chemicals via known transformations. Based on experimental and theoretical studies, a mechanism involving the Pd(II)/(IV) pathway is proposed for this hydroxylation reaction.
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Affiliation(s)
- Jiantao Hu
- MOE Key Laboratory of Protein Sciences, Department of Pharmacology and Pharmaceutical Sciences, School of Medicine, Tsinghua University, Beijing, 100084, China.
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Abdul-Hay SO, Luo J, Ashghodom RT, Thatcher GRJ. NO-flurbiprofen reduces amyloid-beta, is neuroprotective in cell culture, and enhances cognition in response to cholinergic blockade. J Neurochem 2009; 111:766-76. [PMID: 19702655 DOI: 10.1111/j.1471-4159.2009.06353.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The non-steroidal anti-inflammatory drug flurbiprofen is a selective amyloid lowering agent which has been studied clinically in Alzheimer's disease. HCT-1026 is an ester prodrug of flurbiprofen incorporating a nitrate carrier moiety that in vivo provides NO bioactivity and an improved safety profile. In vitro, HCT-1026 retained the cyclooxygenase inhibitory and non-steroidal anti-inflammatory drug activity of flurbiprofen, but at concentrations at which levels of amyloid-beta 1-42 amino acid were lowered by flurbiprofen, amyloid-beta 1-42 amino acid levels were elevated 200% by HCT-1026. Conversely, at lower concentrations, HCT-1026 behaved as a selective amyloid lowering agent with greater potency than flurbiprofen. The difference in concentration-responses between flurbiprofen and HCT-1026 in vitro suggests different cellular targets; and in no case did a combination of nitrate drug with flurbiprofen provide similar actions. In vivo, HCT-1026 was observed to reverse cognitive deficits induced by scopolamine in two behavioral assays; activity that was also shown by a classical nitrate drug, but not by flurbiprofen. The ability to restore aversive memory and spatial working and reference memory after cholinergic blockade has been demonstrated by other agents that stimulate NO/cGMP signaling. These observations add positively to the preclinical profile of HCT-1026 and NO chimeras in Alzheimer's disease.
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Affiliation(s)
- Samer O Abdul-Hay
- Department of Medicinal Chemistry & Pharmacognosy, College of Pharmacy, University of Illinois at Chicago, Chicago, Illinois 60612, USA
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Ward MM. Assessing the relative sensitivity to change of rheumatoid arthritis activity measures: is the type of treatment an important third variable? J Clin Epidemiol 1996; 49:1161-9. [PMID: 8826997 DOI: 10.1016/0895-4356(96)00178-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Observational studies and meta-analyses of controlled clinical trials have been used to identify which measures of rheumatoid arthritis activity are most sensitive to change. These analyses often pool studies of different drugs, although it is not known if arthritis activity measures are differentially responsive to different drugs. In meta-analyses, estimates of the relative sensitivity to change of different measures may also be confounded by differences in drug efficacy, if studies of different drugs contribute different measures to the meta-analysis. To determine if the type of treatment acts as an important effect modifier or confounder in studies of the relative sensitivity to change of arthritis activity measures, we computed effect sizes for four measures (weighted tender joint count, grip strength, duration of morning stiffness, and erythrocyte sedimentation rate) used in each of 16 trials of five different disease-modifying antirheumatic drugs (methotrexate, sulfasalazine, cyclosporin A, intramuscular gold, and D-penicillamine) in rheumatoid arthritis. In a complete factorial analysis of variance, effect sizes differed significantly among drugs (p = 0.0006), but differed only marginally among measures (p = 0.08). No interaction was detectable between drugs and measures. These results suggested that effect modification by drugs was not present, but that pooled estimates of the sensitivity to change of different measures may be confounded in meta-analyses, if trials of more efficacious drugs contribute different measures than trials of less efficacious drugs. In a similar analysis of 26 trials of nine nonsteroidal anti-inflammatory drugs, we found significant differences in effect sizes among measures (p < 0.0001), but no differences among drugs (p = 0.96), and no interaction between drugs and measures. This study suggests that pooled analyses of the relative sensitivity to change of arthritis activity measures based on trials of different disease-modifying drugs may be confounded by drug effects, but confounding by drug effects is unlikely if these meta-analyses are based on trials of different nonsteroidal anti-inflammatory drugs. Although the power of these analyses to detect small interaction effects was limited, effect modification by drugs was not observed, indicating that the measures we examined were not strongly differentially responsive to different drugs.
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Affiliation(s)
- M M Ward
- Palo Alto Veterans Affairs Medical Center, California 94304, USA
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Oga S, Taniguchi SF, Najjar R, Souza AR. Synthesis, characterization, and biological screening of a copper flurbiprofen complex with anti-inflammatory effects. J Inorg Biochem 1991; 41:45-51. [PMID: 2019832 DOI: 10.1016/0162-0134(91)85008-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The flurbiprofen complex of copper(II) was prepared and characterized by IR, UV-VIS and EPR Spectroscopy, magnetic susceptibility, and thermogravimetric analysis. The compound was tested for in vivo anti-inflammatory and analgesic activities in rats. The inhibitory effect on carrageenin-induced paws inflammation and analgesic effect of copper flurbiprofen complex were similar to those of free flurbiprofen. However, the copper complex produced less gastric irritation than the parent drug.
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Affiliation(s)
- S Oga
- Departamento de Farmacologia do Instituto de Ciências Biomédicas, Universidade de São Paulo, Brazil
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Babhair SA. Determination of Flurbiprofen in Dosage form and in Biological Fluids by High Performance Liquid Chromatography. ACTA ACUST UNITED AC 1988. [DOI: 10.1080/01483918809349952] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Karmali RA. Modulation of arachidonic acid metabolism in experimental arthritis induced by Salmonella enteritidis. I. Effect of ibuprofen and flurbiprofen on experimental arthritis induced by Salmonella enteritidis. PROSTAGLANDINS, LEUKOTRIENES, AND MEDICINE 1987; 29:175-9. [PMID: 3124133 DOI: 10.1016/0262-1746(87)90006-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Oral administration of two nonsteroidal anti-inflammatory drugs, ibuprofen and flurbiprofen, can suppress the Salmonella-induced arthritis in rats. The joint swelling index of arthritic paws showed suppression of arthritis in animals treated with the drugs, this effect being greater with flurbiprofen. Measurement of 5 eicosanoids in femoral vein plasma showed increase of arachidonic acid products in Salmonella-treated rats. Inhibition of joint inflammation resulting from treatment with ibuprofen and flurbiprofen is reflected by a decrease in concentration of all 5 eicosanoids which were found in the order: PGE2 greater than TXB2 greater than 6-keto-PGF1 alpha greater than PGF1 greater than PGF2 alpha. These studies indicate that flurbiprofen is a more powerful anti-inflammatory agent than ibuprofen. However, since the joint disease was not completely cured, optimal intervention is quite likely to require modulation of the lipoxygenase pathway.
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Affiliation(s)
- R A Karmali
- Department of Nutrition, Rutgers State University of New Jersey, New Brunswick 08903
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Flath RK, Hicks ML, Dionne RA, Pelleu GB. Pain suppression after pulpectomy with preoperative flurbiprofen. J Endod 1987; 13:339-47. [PMID: 3327906 DOI: 10.1016/s0099-2399(87)80116-4] [Citation(s) in RCA: 52] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Abstract
Numerous European clinical trials begun more than 12 years ago have clearly demonstrated flurbiprofen's safety and efficacy as an analgesic, anti-inflammatory, and antipyretic agent. In preclinical studies, flurbiprofen was at least as potent as indomethacin, and approximately 200 times more potent than aspirin. For patients with rheumatoid arthritis, a review of several trials found flurbiprofen often superior to aspirin and naproxen, and equivalent to indomethacin and ibuprofen in efficacy. Acetaminophen appeared no more effective than placebo for patients with rheumatoid arthritis. For patients with ankylosing spondylitis, flurbiprofen was also shown to be equivalent or superior to indomethacin and phenylbutazone. For patients with osteoarthritis of the peripheral joints, spine, hip, and knee, flurbiprofen was again found equal to ibuprofen, diclofenac, indomethacin, and naproxen. Side effects with flurbiprofen were few and predominantly related to the gastrointestinal tract.
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Sunshine A, Marrero I, Olson N, McCormick N, Laska EM. Comparative study of flurbiprofen, zomepirac sodium, acetaminophen plus codeine, and acetaminophen for the relief of postsurgical dental pain. Am J Med 1986; 80:50-4. [PMID: 3515924 DOI: 10.1016/0002-9343(86)90111-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
The relative analgesic efficacy and safety of single oral doses of 50 and 100 mg of flurbiprofen (Ansaid, Upjohn) were compared with 100 mg of zomepirac sodium, 650 mg of acetaminophen plus 60 mg of codeine, 650 mg of acetaminophen alone, and placebo in a randomized, double-blind, parallel-group study. A total of 182 patients entered the study with moderate pain from a third molar extraction and were evaluated for six hours. For many efficacy variables, all active treatments were significantly (p less than or equal to 0.05) more effective than placebo. The two doses of flurbiprofen gave approximately similar results, suggesting a plateau effect above 50 mg. With the exception of relief at one hour, there were no significant differences between zomepirac and either dose of flurbiprofen. However, the mean response with zomepirac was greater than with either 50 or 100 mg of flurbiprofen during the first four hours and lower during the last two hours. The analgesic effects of acetaminophen alone were not significantly different from acetaminophen in combination with codeine. At the first hour, acetaminophen plus codeine led to significantly better pain relief than did 100 mg of flurbiprofen. After the first hour, flurbiprofen resulted in greater mean scores than acetaminophen alone or acetaminophen plus codeine, and these differences were significant at the fifth and sixth hours. Five patients had adverse reactions while receiving acetaminophen, acetaminophen plus codeine, or placebo. There were no adverse effects with flurbiprofen or zomepirac.
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Rogers DF, Jeffery PK. Indomethacin and flurbiprofen speed recovery of rat bronchial epithelium after exposure to cigarette smoke. Exp Lung Res 1986; 10:299-312. [PMID: 3698930 DOI: 10.3109/01902148609061499] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The cigarette smoke-induced rat model of chronic bronchitis was used to study the time course of the return of cigarette smoke-induced secretory cell hyperplasia to the normal and the capacity of two non-steroidal anti-inflammatory drugs to speed this recovery. Cigarette smoke alone significantly increased (P less than 0.05) the number of secretory cells in all of the eight airway levels studied to between 52-225% above control values. After cessation of exposure, recovery was complete by 9 days in the trachea, between 10-21 days in 'proximal' intrapulmonary airways and 43-84 days in distal bronchioli. Indomethacin and flurbiprofen, given by intraperitoneal injection at 4 mg/kg body weight for 21 days of the recovery period, significantly reduced the time taken for recovery to between 4 and 9 days in intrapulmonary airways but had no effect in the trachea.
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Williams RC, Jeffcoat MK, Kaplan ML, Goldhaber P, Johnson HG, Wechter WJ. Flurbiprofen: a potent inhibitor of alveolar bone resorption in beagles. Science 1985; 227:640-2. [PMID: 3969553 DOI: 10.1126/science.3969553] [Citation(s) in RCA: 154] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The nonsteroidal anti-inflammatory drug, flurbiprofen, a potent cyclooxygenase inhibitor, significantly decreases the resorption of alveolar bone in naturally occurring chronic destructive periodontal disease in beagles. This observation indicates that arachidonic acid metabolites are important in the alveolar bone loss of periodontitis and suggests a use for flurbiprofen in the management of bone resorption disease.
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Albert KS, Gillespie WR, Raabe A, Garry M. Determination of flurbiprofen in human serum by reverse-phase high-performance liquid chromatography with fluorescence detection. J Pharm Sci 1984; 73:1823-5. [PMID: 6527267 DOI: 10.1002/jps.2600731242] [Citation(s) in RCA: 28] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
A reverse-phase high-performance liquid chromatographic method is described for the determination of flurbiprofen in human serum. Flurbiprofen is extracted from hydrochloric acid-acidified serum with pentane-ether (80:20). An octadecylsilane column was used with a mobile phase of acetonitrile-water-phosphoric acid (650:350:0.5, v/v/v). A fluorescence detector with excitation at 250 nm and emission at 315 nm provided a quantifiable peak for 0.1 microgram/mL of flurbiprofen in 0.5 mL of plasma. A comparison between UV and fluorescence detection systems is presented. The method is applicable to human bioavailability and pharmacokinetic studies with flurbiprofen.
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Sunshine A, Olson NZ, Laska EM, Zighelboim I, De Castro A, De Sarrazin C. Analgesic effect of graded doses of flurbiprofen in post-episiotomy pain. Pharmacotherapy 1983; 3:177-81. [PMID: 6348714 DOI: 10.1002/j.1875-9114.1983.tb03246.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Our purpose was to evaluate the analgesic efficacy and safety of single oral doses of flurbiprofen 25, 50 and 100 mg, aspirin 600 mg, and placebo in the relief of moderate to severe post-episiotomy pain. One hundred and fifty-two evaluable patients completed a randomized, double-blind, stratified, parallel groups study. They were observed over a six hour period by one nurse-observer. Based upon each of the summary efficacy measures SPID, TOTAL and PEAK % and most of the hourly direct measures of pain intensity and pain relief, each of the four active treatments were statistically superior to placebo. Flurbiprofen 25 mg appeared to be slightly less effective than aspirin 600 mg, but the differences were not statistically significant. Flurbiprofen 50 and 100 mg were quite similar and were significantly more effective than aspirin 600 mg and flurbiprofen 25 mg. There were no observed or reported adverse effects.
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Brogden RN, Heel RC, Speight TM, Avery GS. Flurbiprofen: a review of its pharmacological properties and therapeutic use in rheumatic diseases. Drugs 1979; 18:417-38. [PMID: 391529 DOI: 10.2165/00003495-197918060-00001] [Citation(s) in RCA: 69] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Flurbiprofen, a phenylalkanoic acid derivative, is a non-steroidal anti-inflammatory, antipyretic, analgesic agent advocated for use in rheumatoid arthritis, degenerative joint disease, ankylosing spondylitis and allied conditions. Published data suggest that flurbiprofen 120 to 150 mg daily is comparable in effectiveness with therapeutic doses of aspirin (3 to 4 g) in rheumatoid arthritis, but generally causes fewer side effects. Flurbiprofen 150 to 300 mg appears to be comparable with 75 to 150 mg of indomethacin in rheumatoid arthritis and degenerative joint disease, and comparable with phenylbutazone or indomethacin in ankylosing spondylitis. In comparison with other non-steroidal agents, flurbiprofen appears to be at least as effective as naproxen, ibuprofen or sulindac, but generally causes more side effects than these drugs. However, as no one of the non-steroidal anti-inflammatory agents is the most suitable drug for all patients requiring such therapy, flurbiprofen should be considered along with other drugs of its type in the arthritic patient.
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Pitney WR, Nicol M, Dean S, Hickey A. Effect of flurbiprofen on bleeding time and platelet aggregation. Thromb Res 1978; 13:811-9. [PMID: 741454 DOI: 10.1016/0049-3848(78)90186-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Kruger HH. Flurbiprofen and indomethacin in the treatment of rheumatoid arthritis: a double-blind crossover study. Curr Med Res Opin 1977; 5:77-84. [PMID: 334477 DOI: 10.1185/03007997709108981] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
A double-blind crossover study was carried out in 30 patients with rheumatoid arthritis to compare the effectiveness of 300 mg flurbiprofen daily with that of 150 mg indomethacin daily. Each drug was given in random order for 2 weeks, each period being preceded by a wash-out period of 2 weeks during which patients received paracetamol. With the exception of joint size and erythrocyte sedimentation rate, both drugs showed a statistically significant improvement when compared individually to baseline in all of the parameters assessed. There were no statistically significant differences between the two drugs when both treatments were compared. Three patients reported side-effects with flubiprofen and 3 with indomethacin, 1 of whom had to be withdrawn from the trial.
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Abstract
A double-blind, crossover study was carried out in 30 patients with active, classical or definite rheumatoid arthritis to compare the effect of 200 mg flurbiprofen per day with that of 100 mg indomethacin per day. Patients received, at random, each drug for a period of 2 weeks separated by a weeks' wash-out period on placebo. Assessments were made before the start of the trial and at weekly intervals of pain, morning stiffness, grip strength, articular index, walking time, and finger joint size. Patients' preference for any particular treatment period was recorded at the end of the trial. Laboratory investigations were carried out before and during the trial. Both drugs shows statistically significant improvement over baseline assessments, although there was little difference between the two active treatment periods. More patients preferred the treatment period with flurbiprofen, and this was probably related to the fewer side-effects which were reported with this drug.
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Mena HR, Ward JR, Zuckner J, Wolski KP, Briney WG, Giansiracusa J. Treatment of rheumatoid arthritis with flurbiprofen or ibuprofen. J Clin Pharmacol 1977; 17:56-62. [PMID: 319117 DOI: 10.1002/j.1552-4604.1977.tb04586.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Flurbiprofen and ibuprofen were compared in a six-week double-blind randomized study in 208 patients with rheumatoid arthritis. Daily dosages were 120 mg flurbiprofen and 2400 mg ibuprofen for six weeks. Both drugs were effective in providing partial control of RA symptoms. Either or both drugs produced statistically significant improvement in mean values of time of onset of fatigue, grip strength and tender and swollen joint counts. All other standard endpoints of efficacy (except ESR) were improved but not at a statistically significant level. Slightly more than half of the patients improved during the trial. There was no statistically significant difference in the efficacy of the drugs. The incidence of side effects was low with both drugs. Most side effects were related to gastrointestinal tract irritation.
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McKenzie LS, Horsburgh BA, Ghosh P, Taylor TK. Effect of anti-inflammatory drugs on sulphated glycosaminoglycan synthesis in aged human articular cartilage. Ann Rheum Dis 1976; 35:487-97. [PMID: 1008617 PMCID: PMC1006591 DOI: 10.1136/ard.35.6.487] [Citation(s) in RCA: 76] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The anti-inflammatory drugs, sodium salicylate, indomethacin, hydrocortisone, ibuprofen, and flurbiprofen, were examined for their effects on sulphated glycosaminoglycan synthesis in aged human cartilage in vitro. Cartilage was obtained from femoral heads removed during surgery and drug effects were found to vary significantly from one head to another. Statistical analysis of the results showed that sodium salicylate exhibits concentration-dependent inhibition of glycosaminoglycan synthesis over the concentration range used. Indomethacin, hydrocortisone, and ibuprofen, at concentrations comparable to those attained in man, caused a statistically significant depression of sulphated glycosaminoglycan synthesis in cartilage from some femoral heads but not others, reflecting the variable response of human articular cartilage to anti-inflammatory drugs. Sodium salicylate and indomethacin at higher doses produced significant (Pless than 0-005) inhibition of sulphated glycosaminoglycan synthesis in all femoral heads studied. The results for flurbiprofen were less conclusive; this compound appears not to inhibit glycosaminoglycan synthesis over the concentration range used.
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Crook D, Collins AJ, Rose AJ. A comparison of the effect of flurbiprofen on prostaglandin synthetase from human rheumatoid synovium and enzymatically active animal tissues. J Pharm Pharmacol 1976; 28:535. [PMID: 7661 DOI: 10.1111/j.2042-7158.1976.tb02787.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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24
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Mizushima Y, Ishii Y, Masumoto S. Physico-chemical properties of potent nonsteroidal anti-inflammatory drugs. Biochem Pharmacol 1975; 24:1589-92. [PMID: 1191318 DOI: 10.1016/0006-2952(75)90084-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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25
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Smith ID, Temple DM, Shearman RP. The antagonism by anti-inflammatory analgesics of prostaglandin f 2 alpha-induced contractions of human and rabbit myometrium in vitro. PROSTAGLANDINS 1975; 10:41-57. [PMID: 1153803 DOI: 10.1016/0090-6980(75)90092-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The anti-inflammatory analgesic drugs, aspirin, indomethacin, phenylbutazone, mefenamic acid ibuprofen and flurbiprofen are shown to inhibit in a dose-dependent manner the force of contraction of isolated human pregnant myometrial strips which have been stimulated to contract by adding prostaglandin (PG) F2alpha to the tissue bath. These drugs and also flufenamic acid and salicin show a similar antagonism of the action of PGF2alpha with isolated rabbit non-pregnant myometrium. The ratio of the inhibitory concentration in vitro to the maximum plasma level after a normal dose in vivo suggests that phenylbutazone and possibly ibuprofen may be capable of inhibiting human uterine contractions in vivo. Patients who were treated with aspirin during induction of abortion using PGF2alpha during the second trimester of pregnancy showed no significant change in the induction-abortion interval compared with patients not taking aspirin.
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Barraclough DR, Lenaghan E, Muirden KD. A comparison of flurbiprofen and aspirin in the treatment of rheumatoid arthritis. Med J Aust 1974; 2:925-7. [PMID: 4616159 DOI: 10.5694/j.1326-5377.1974.tb93775.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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27
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Calin A, Grahame R. Double-bind cross-over tiral of flurbiprofen and phenylbutazone in ankylosing spondylitis. BRITISH MEDICAL JOURNAL 1974; 4:496-9. [PMID: 4611579 PMCID: PMC1612601 DOI: 10.1136/bmj.4.5943.496] [Citation(s) in RCA: 35] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
A double-blind cross-over study in 35 patients with ankylosing spondylitis was carried out comparing flurbiprofen (150 mg daily)-a new non-steroidal anti-inflammatory agent-with phenylbutazone (300 mg daily) over a four-week period. Flurbiprofen was well tolerated and shown to have therapeutic efficacy approaching that of phenylbutazone. The results suggest that flurbiprofen may prove a valuable alternative in the treatment of ankylosing spondylitis, and longterm efficacy and tolerance studies are clearly indicated.
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Davies T, Lederer DA, Spencer AA, McNicol GP. The effect of flurbiprofen (2-(2-fluoro-4-biphenylyl) propionic acid) on platelet function and blood coagulation. Thromb Res 1974; 5:667-83. [PMID: 4445988 DOI: 10.1016/0049-3848(74)90056-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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30
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Kaiser DG, Shaw SR, Vangiessen GJ. GLC determination of dl-2-(2-fluoro-4-biphenylyl)propionic acid (flurbiprofen) in plasma. J Pharm Sci 1974; 63:567-70. [PMID: 4828706 DOI: 10.1002/jps.2600630415] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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31
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Sturrock RD, Hart FD. Double-blind cross-over comparison of indomethacin, flurbiprofen, and placebo in ankylosing spondylitis. Ann Rheum Dis 1974; 33:129-31. [PMID: 4595274 PMCID: PMC1006225 DOI: 10.1136/ard.33.2.129] [Citation(s) in RCA: 43] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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32
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Sturrock RD, Watkin C, Williamson T, Dick WC. Intra-articular urokinase in rheumatoid arthritis. Ann Rheum Dis 1974; 33:124-5. [PMID: 4821384 PMCID: PMC1006223 DOI: 10.1136/ard.33.2.124] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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33
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Glenn EM, Rohloff N, Bowman BJ, Lyster SC. The pharmacology of 2-(2-fluoro-4-biphenylyl)propionic acid (flurbiprofen). A potent non-steroidal anti-inflammatory drug. AGENTS AND ACTIONS 1973; 3:210-6. [PMID: 4776365 DOI: 10.1007/bf01968544] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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34
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Chalmers IM, Bell MA, Buchanan WW. Effect of flurbiprofen on the metabolism of antipyrine in man. Ann Rheum Dis 1973; 32:58-61. [PMID: 4539857 PMCID: PMC1006035 DOI: 10.1136/ard.32.1.58] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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35
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Cathcart BJ, Vince JD, Gordon AJ, Bell MA, Chalmers IM. Studies on 2-(3-benzoylphenyl) propionic acid (Orudis). A double-blind cross-over trial in patients with rheumatoid arthritis and an assessment of its influence on hepatic drug-metabolizing enzymes. Ann Rheum Dis 1973; 32:62-5. [PMID: 4568350 PMCID: PMC1006036 DOI: 10.1136/ard.32.1.62] [Citation(s) in RCA: 28] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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