Current medical research and opinion
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Ibuprofen and diclofenac sodium in the treatment of osteoarthritis: a comparative trial of two once-daily sustained-release NSAID formulations.
An investigator-blind, parallel-group, multicentre study was undertaken to compare the efficacy and tolerability of once-daily, sustained-release (s-r) ibuprofen and diclofenac sodium in patients (mean age 59.8 years) suffering from painful osteoarthritis affecting chiefly the knee and/or hip. Patients attending eight Swiss centres received either two s-r tablets of ibuprofen (daily dose 1600 mg; n = 30) or a single s-r diclofenac 100 mg tablet (n = 31) each evening for 21 days. Clinical assessments were performed prior to initiating therapy and after 7 and 21 days of treatment. ⋯ In conclusion, although both NSAID treatments improved the clinical condition of patients with painful osteoarthritis, statistically significant differences in favour of once-daily s-r ibuprofen (1600 mg) were demonstrated in terms of efficacy, indicating a potential therapeutic advantage for this formulation. Ibuprofen was also better tolerated than diclofenac sodium (100 mg/day), the latter being associated with gastrointestinal side effects in a significant proportion of patients. Sustained-release ibuprofen (Brufen Retard) thus represents an important addition to the available therapeutic armamentarium of once-daily NSAID formulations.
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Randomized Controlled Trial Comparative Study Clinical Trial
Investigation into the duration of action of sustained-release ibuprofen in osteoarthritis and rheumatoid arthritis.
The duration of action of sustained-release ibuprofen ('Brufen Retard') was investigated in a 14-day double-blind study involving 14 osteoarthritis and 10 rheumatoid arthritis patients. The recommended once-daily dosage of this preparation (1600 mg taken in the evening) provided effective control of arthritic symptoms for both patient groups, with significant overall improvements in pain and stiffness compared to baseline. ⋯ The 24-hour clinical action underlying these findings is consistent with ibuprofen plasma profiles obtained with the sustained-release preparation in earlier pharmacokinetic studies. It is likely that the greater sensitivity of rheumatoid patients to withdrawal of a single day's active treatment in this study reflects a more severe inflammatory disease process than that of the osteoarthritis patients.
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Randomized Controlled Trial Multicenter Study Clinical Trial
The efficacy and tolerability of controlled-release dihydrocodeine tablets and combination dextropropoxyphene/paracetamol tablets in patients with severe osteoarthritis of the hips.
A double-blind, parallel group study was undertaken in general practice to compare the efficacy of and tolerability to controlled-release (CR) dihydrocodeine tablets and combination dextropropoxyphene/paracetamol tablets in patients with severe osteoarthritis of the hip(s). Eighty-six patients were randomly allocated to receive either CR dihydrocodeine (60 mg) tablets (1 tablet twice daily to 2 tablets daily) or combination dextropropoxyphene (32.5 mg)/paracetamol (325 mg) tablets (2 tablets 3-times daily to 2 tablets 4-times daily) for a period of 2 weeks. Patients recorded in a diary card 4 times a day the severity of their pain and each morning whether or not they woke during the night due to pain in their hip(s). ⋯ Tolerance in terms of withdrawals or side-effect profile did not appear to the dosage of each preparation administered. It is concluded that after 2-weeks' treatment CR dihydrocodeine provided superior analgesia to dextropropoxyphene/paracetamol with no difference in side-effects. Furthermore, CR dihydrocodeine has the advantage of twice rather than 3 or 4-times daily dosing.
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Randomized Controlled Trial Comparative Study Clinical Trial
A single-blind, randomized study to compare the efficacy of two ear drop preparations ('Audax' and 'Cerumol') in the softening of ear wax.
A parallel group, single-blind, randomized study was carried out in a general practice to compare the effectiveness and tolerability of two ear drop preparations ('Audax' and 'Cerumol') in the softening of ear wax in 50 adult patients with impacted or hardened ear wax. Assessments were made on entry of the amount, colour and consistency of the ear wax, symptoms, and objective hearing. Patients were then allocated at random to receive one or other preparation and instructed to use the drops, morning and evening, for 4 days after which they were reassessed. ⋯ Both treatments were shown to be effective in the softening of ear wax and were well tolerated, there being no significant difference between the two groups in these parameters. However, patients who had abnormal hearing before treatment had a significantly greater improvement in objective hearing after treatment with 'Audax' ear drops compared to those patients treated with 'Cerumol' ear drops. There were no between-treatment differences in either either the physician's or patient's overall assessments of effectiveness.
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Randomized Controlled Trial Clinical Trial
The efficacy of pre-operative controlled-release indomethacin in the treatment of post-operative pain.
A double-blind, placebo-controlled study in patients undergoing lumbar laminectomy was carried out to assess the morphine-sparing effect of a controlled-release indomethacin formulation ('Flexin Continus' tablets, 75 mg). Thirty patients were randomly allocated to receive 1 tablet of active or placebo study medication pre-operatively and their pain scores on visual analogue scale (VAS) and their morphine consumption, delivered by Patient Controlled Analgesia (PCA), were recorded over the 24-hour post-operative period. ⋯ At the 12-hour time point, the difference in morphine consumption approached statistical significance (p = 0.074). It is concluded that the pre-operative administration of controlled-release indomethacin reduces post-operative morphine requirements and significantly reduces VAS pain scores on recovery.