Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1016/j.bjane.2013.12.003
Brazilian Journal of Anesthesiology
Scientific Article

Comparison of the effectivity of oral and intra-articular administration of tenoxicam in patients with knee osteoarthritis

Comparação da eficácia de tenoxicam administrado por via oral e intra-articular a pacientes com osteoartrite de joelhos

Mesut Erbas; Tuncer Simsek; Hasan Ali Kiraz; Hasan Sahin; Huseyin Toman

http://dx.doi.org/10.1016/j.bjane.2013.12.003 Braz J Anesthesiol, vol.65, n5, p.333-337, 2015
PDF English
PDF Português
Downloads: 0
Views: 870

Abstract

ABSTRACTBACKGROUND AND OBJECTIVES:Tenoxicam is widely used in osteoarthritis treatment and we aimedto compare the effectivity of oral and intra-articular administration of tenoxicam in osteoarthri-tis treatment.METHODS: This study was performed between 2011 and 2012 by retrospectively analyzing andcomparing the findings of 60 patients who were clinically and radiologically diagnosed with kneedegenerative osteoarthritis in Bünyan state hospital pain policlinic. 60 patients included in thestudy were divided into two groups. The first group (tenoxicam IA, n = 30) included patientfindings of those subjected to intra-articular injection of 20 mg tenoxicam to the knee oncea week for three weeks and the second group (oral tenoxicam, n = 30) included patients whowere administered 20 mg oral tenoxicam once a day for three weeks. All patients were clini-cally evaluated pre-treatment and in the 1st week, 1st month and 3rd month post-treatmentaccording to specified criteria.RESULTS AND CONCLUSIONS: Twenty two of 60 patients included in the study were male and 38were female. In both groups significant improvements were detected in all of the observedparameters: visual analog scale, Western Ontario McMaster Osteoarthritis Index (pain, physicalactivity, knee stiffness) and Lequesne index scores and in the evaluations performed in 1st week,1st month and 3rd month with respect to pre-treatment values. Besides, a better complianceto treatment and gastrointestinal system tolerability in tenoxicam IA group was also observed.Intra-articular tenoxicam administration could be thought as an alternative treatment methodin patients with knee osteoarthritis who cannot use oral tenoxicam especially due to systemicgastrointestinal system side effects and those who have difficulties in adapting to treatment.

Keywords

Osteoarthritis, Tenoxicam, Knee, Intra-articular administration

Resumo

RESUMOJUSTIFICATIVA E OBJETIVOS: Tenoxicam é amplamente usado no tratamento da osteoartrite (OA)e o nosso objetivo foi comparar a eficácia de tenoxicam administrado por via oral (VO) e intra-articular (IA) no tratamento da OA.MÉTODOS: Este estudo foi conduzido entre 2011 e 2012 por meio de análise retrospectiva ecomparação dos resultados de 60 pacientes que foram clínica e radiologicamente diagnosticadoscom OA degenerativa de joelhos na Policlínica de Tratamento da Dor do Hospital Estadual deBünyan. Os 60 pacientes incluídos no estudo foram alocados em dois grupos. O primeiro grupo(tenoxicam IA, n = 30) incluiu resultados de pacientes submetidos à injeção nos joelhos porvia IA de 20 mg de tenoxicam uma vez por semana durante três semanas e o segundo grupo(tenoxicam VO, n = 30) incluiu pacientes que receberam 20 mg de tenoxicam por VO uma vezpor dia durante três semanas. Todos os pacientes foram avaliados clinicamente na fase basalpré-tratamento e em uma semana, um mês e três meses pós-tratamento, de acordo com oscritérios especificados.RESULTADOS E CONCLUSÕES: Dos 60 pacientes, 22 eram do sexo masculino e 38 do sexo feminino.Em ambos os grupos, melhorias significativas foram detectadas em todos os parâmetros da escalavisual analógica, do índice Western Ontario and MacMaster (Womac --- dor, atividade física erigidez dos joelhos) e do índice de Lequesne nas avaliações feitas em uma semana, um mês etrês meses e comparadas aos valores basais. Além disso, uma melhor adesão ao tratamento etolerabilidade ao sistema gastrointestinal no grupo tenoxicam IA também foram observadas. Aadministração de tenoxicam IA pode ser considerada como um método opcional de tratamentoem pacientes com OA de joelhos que não podem usar tenoxicam por VO, especialmente porcausa dos efeitos colaterais sobre o sistema gastrintestinal, e naqueles com dificuldades de adaptação ao tratamento.

Palavras-chave

Osteoartrite, Tenoxicam, Joelhos, Administração intra-articular

References

Vanelli R, Costa P, Marco S,. Efficacy of intra-articular polynucleotides in the treatment of knee osteoarthritis: a ran- domized, double-blind clinical trial. Knee Surg Sports Traumatol Arthrosc. 2010;18:901-7.

Seed SM, Dunican KC, Lynch AM. Osteoarthritis: a review of treatment options. Geriatrics. 2009;64:20-9.

Ergin S. Pain mechanisms in osteoarthritis and current thera- peutic approaches. Turk J Geriatr. 2011;14(^s1):63-7.

Neustadt DH. Intra-articular injections for osteoarthritis of the knee. Cleve Clin J Med. 2006;73:897-911.

Unlu Z, Ay K, Tuzun C. Comparison of intra-articular tenoxi- cam and oral tenoxicam for pain and physical functioning in osteoarthritis of the knee. Clin Rheumatol. 2006;25:54-61.

Bjordal JM, Klovning A, Ljunggren AE,. Short-term efficacy of pharmacotherapeutic interventions in osteoarthritic knee pain: a meta-analysis of randomised placebocontrolled trials. Eur J Pain. 2007;11:125-38.

Chan FK, Wong VW, Suen BY. Combination of a cyclo-oxygenase- 2 inhibitor and a proton pump inhibitor for prevention of recurrent ulcer bleeding in patients at very high risk: a double- blind, randomised trial. Lancet. 2007;369:1621-6..

Kennedy S, Moran M. Pharmacological treatment of osteoarthri- tis of the hip and knee. B C Med J. 2010;52:404-9.

Public Statement announces regula-tory action on COX-2 inhibitors. 2011.

FDA announces series of changes to the class of marketed NSAIDs. 2011.

Cook TM, Tuckey JP, Nolan JP. Analgesia after daycase knee arthroscopy: double-blind study of intra-articular tenoxi- cam, intra-articular bupivacaine and placebo. Br J Anaesth. 1997;78:163-8.

Papathanassiou N P. Intraarticular use of tenoxicam in degen- erative osteoarthritis of the knee joint. J Int Med Res. 1994;22:332-7.

Colbert ST, Curran E, O'Hanlon DM,. Intra-articular tenoxi- cam improves postoperative analgesia in knee arthroscopy. Can J Anaesth. 1999;46:653-7.

Manicourt DH, Druetz- Van Egeren A, Haazen L,. Effects of tenoxicam and asprin on the metabolism of proteoglycans and hyaluronan in normal and osteoarthritic human articular cartilage. Br J Pharmacol. 1994;113:1113-20.

Vignon E, Mathieu P, Louisot P,. In vitro effect of nonsteroidal antiinflamatory drugs on proteoglycanase and col- lagenase activity in human osteoarthritic cartilage. Arthritis Rheum. 1991;34:1332-5.

Nilsen OG. Clinical pharmacokinetics of tenoxicam. Clin Phar- macokinet. 1994;26:16-43.

5dcdbf420e8825d61abf58f1 rba Articles
Links & Downloads
2352-2291 (Electronic) 0104-0014 (Printed)
Braz J Anesthesiol ©2024 All rights reserved.

Braz J Anesthesiol

Share this page
Page Sections