Section 2 ‘Brufen’ in the treatment of rheumatoid disease in patients with gastric intolerance

Summary

Ibuprofen was administered to 64 patients with known peptic ulceration and to 42 patients with gastric intolerance of other antirheumatic drugs for periods up to 5 years. Twenty-six patients are continuing therapy and in a further 23, treatment was maintained long enough for remission to occur, either medically or surgically induced. Only 13 (12.3 %) of this specially selected, difficult group of patients withdrew because of gastric side-effects. This compares favourably with the reported incidence of similar side-effects produced by other non-steroidal anti-inflammatory agents.     

Section 3 Clinical experience with ibuprofen in the treatment of rheumatic diseases

Summary

Ibuprofen in a dosage of 1200?mg. daily was shown in an open study of 247 patients to be effective in the treatment of rheumatoid arthritis, ankylosing spondylitis and non-articular rheumatism. Side-effects were minimal and particularly noteworthy was the absence of gastro-intestinal symptoms in 26 patients with known peptic ulceration who were treated with the drug.     

Section 3 The activity and tolerance of ibuprofen in patients with rheumatism and associated conditions

Summary

Ibuprofen, in a daily dosage range of 600?mg. to 1200?mg., was given to 100 patients suffering from a variety of rheumatic conditions for periods ranging from 1 to 3 months. The drug was found to be effective and well-tolerated by the majority of patients, even by those with associated conditions such as gastro-intestinal disorders which often make treatment difficult with other antirheumatic agents. Side-effects were reported in only 4 patients.     

Section 3 A multi-centre clinical evaluation,with proctoscopic control,of the use of ibuprofen suppositories in rheumatic conditions

Summary

Sixty-three patients, suffering from osteoarthrosis, rheumatoid arthritis and allied disorders, were admitted to a multi-centre, open study using 500?mg. ibuprofen suppositories. The results indicate that this is an effective form of therapy, night pain being relieved in 75% of the patients. Proctoscopic examinations carried out during the study confirmed good local tolerance.     

Section 2 Use of ibuprofen as an anti-inflammatory drug in the treatment of phlebitis

Summary

Twenty-three patients with thrombophlebitis were treated with 1200?mg. ibuprofen daily. Their symptoms regressed rapidly with marked relief. It is of interest that the group of patients also receiving anticoagulants demonstrated no evidence of drug interaction.     

Section 2 Comparative clinical trial of three propionic acid derivatives(ibuprofen,ketoprofen and naproxen) in rheumatic diseases

Summary

A comparative study was carried out in 30 patients with rheumatic disease to assess the effectiveness and tolerance of 1200?mg. ibuprofen, 300?mg. ketoprofen, and 1000?mg. naproxen daily. The trial lasted 2 months, ibuprofen and ketoprofen being given in alternating 15-day periods to 15 of the patients, and ibuprofen and naproxen given similarly to the other 15 patients. The results, as assessed by patients and physician, showed similar efficacy against pain for all three drugs, with a slight tendency in favour of ibuprofen. Ibuprofen was much better tolerated and even allowed a return to normal in some patients with gastric intolerance of the other drugs. Overall assessment of treatment showed a clear patient preference for ibuprofen.     

Section 2 The comparison of four non-steroidal antirheumatic agents in the treatment of rheumatic diseases

Summary

A comparative open study was made of the effectiveness of four antirheumatic agents in the treatment of 69 hospitalised patients with rheumatic diseases who had failed to respond satisfactorily to previous therapies. Simple subjective and objective assessments showed that approximately half the patients treated with ibuprofen, oxyphen-butazone or mefenamic acid showed improvement, but that fewer did so with flufenamic acid. Full therapeutic effect of the drugs was evident in approximately 3 weeks.     

Section 3 The effect of ibuprofen on the liver function tests in chronic rheumatic diseases

Summary

Ibuprofen was given to 48 patients with chronic rheumatic disease in doses of 1200?mg. daily for a period of 28 days. Laboratory investigations were carried out before and after treatment to assess the effect of ibuprofen on liver function and other biochemical parameters. The results suggest that ibuprofen has no hepatotoxicity and, except for the erythrocyte sedimentation rate and serum electrophoresis, mean values for all the recorded parameters were within the normal limits.     

Section 1 Use of ibuprofen in obstetric and gynaecological pathology

Summary

In a study of 22 female patients with a variety of pelvic inflammatory conditions, ibuprofen (900 to 1800?mg. daily) was given, in association with chemotherapy where appropriate, for the relief of symptoms such as pain and pyrexia. Response was normally rapid and rated as excellent or good in about 86 % of patients when assessed subjectively and in 59% when assessed objectively. A favourable response was particularly apparent in acute and sub-acute cases. Ibuprofen was very well tolerated, side-effects being reported in only 2 patients.     

Section 3 Algodystrophies in the upper and lower limbs treated with ibuprofen

Summary

Fifty patients suffering from painful conditions in the upper and lower limbs arising from a variety of different causes were treated with 1000?mg. to 1200?mg. ibuprofen daily for periods up to 6 months. Treatment was found to be effective in terms of pain relief and the drug was well tolerated, only 2 patients developing side-effects.     

Section 1 The use of ibuprofen in ophthalmology

Summary

In a study to assess the value of ibuprofen in ophthalmological practice, 138 patients were treated with 600 to 900?mg. daily for periods ranging from 6 to 45 days. Ibuprofen was used alone in 94 patients who had undergone operations on the eyeball, and as associated therapy in 44 patients with endocular inflammatory conditions. The results were compared with those obtained in similar groups of patients treated normally. An excellent to good response, in terms of pain relief and reduction of inflammation or swelling, was seen in 78.7% of the post-operative patients and in 75% of those in the second group treated with ibuprofen. The drug was well tolerated. Side-effects were minimal and there was no interference with post-operative healing or effect on endocular tension.     

Section 3 The absence of effect of the antirheumatic drug ibuprofen on Oral anticoagulation with phenprocoumon

Summary

Nineteen patients receiving oral anticoagulant therapy with phenprocoumon were treated concomitantly with 600?mg. ibuprofen daily for 2 weeks. Plasma concentrations of phenprocoumon, bleeding time, prothrombin time and the concentration of a number of coagulation factors were measured before, during and after ibuprofen treatment. No significant changes were noted in any of the parameters measured and no bleeding was reported in any patient. It is concluded that ibuprofen can be given safely to patients on long-term anticoagulant therapy.     

Section 2 Thrombophlebitis of the lower limbs: therapy with2-(4-isobutylphenyl)propionic acid

Summary

A trial was carried out to assess the value of ibuprofen in relieving the symptoms and signs in 40 patients suffering from inflammatory phlebopathies of the lower limbs. Ibuprofen was given in a dosage of 900?mg. daily for periods ranging from 7 to 28 days. Spontaneous pain, redness and oedema showed a marked reduction, on average by the third day, although pain on pressure persisted for about 10 days. Body temperature returned to normal within a few hours. The results were assessed as excellent in 10, good in 19,fair in 8, and poor in 3 patients. Side-effects were reported inonly 3 patients and were mild.     

A comparative trial of ketoprofen and ibuprofen in patients with rheumatic disease

Summary

A comparative controlled study was carried out in 40 patients suffering from rheumatoid arthritis, osteoarthrosis or ankylosing spondylitis to assess the efficacy of ketoprofen and ibuprofen. Patients were allocated at random to receive either 100?mg ketoprofen twice daily or 400?mg ibuprofen 3-times daily over a period of 3 months. Subjective overall assessments of symptoms, based on rating scale scores for pain, duration of morning stiffness and inflammation, showed that there was a greater, more rapid and more sustained improvement in those patients treated with ketoprofen. Measurements of inflamed joint size and of grip strength also improved more with ketoprofen than with ibuprofen. Side-effects, notably nausea, epigastric discomfort and abdominal pain, were more frequent and severe with ketoprofen, leading to the withdrawal of 2 patients in the early stage of the trial, and were probably related to the high dosage used. Three patients receiving ibuprofen needed 7 injections of ACTH to control their symptoms.     

Section 3 Clinical studies of ibuprofen

Summary

Essential data from 3 studies on ibuprofen are presented. In an open multi-centre general practice study in 571 patients with osteoarthrosis, rheumatoid arthritis and various musculoskeletal conditions, a favourable response was obtained in 77% treatedwith800mg.to1200mg.ibuprofen daily overa 1-month period. In a double-blind crossover comparison of 1200?mg. ibuprofen with 75?mg. indomethacin in 24 patients with osteoarthrosis of the spine, both drugs proved to be equally effective but side-effects were less with ibuprofen. The final study in 21 patients showed that ibuprofen was more effective thanplacebo in controlling post-operative pain, trismus and oedema following minor oral surgical procedures.     

Section 3 The tolerance and acceptability of ibuprofen (‘Brufen’) in the elderly patient

Summary

Data on the treatment of patients over the age of 65 years were extracted from the computer records of a long-term multi-centre study of ibuprofen. Patients were suffering from rheumatoid disease, osteoarthrosis or an allied condition. Records from 231 patients were available for analysis. Duration of therapy with ibuprofen ranged from 3 months to over 5 years. Assessments of clinical progress, as judged by both patients and physicians, changes in biochemical and haematological parameters, and side-effects showed that ibuprofen is an effective form of therapy and is generally well tolerated in the elderly.     

Section 3 Clinical evaluation of ibuprofen given orally and rectally,in degenerative arthroses

Summary

In an open assessment in 46 patients with chronic arthritic and allied disorders, ibuprofen was administered in both oral and suppository form for an average of 10 days. Total daily dosage ranged from 1300?mg. to 1700?mg. ibuprofen depending on the weight of the patient. Pain relief was assessed as very good or good in 56.5 % and moderate in 26 % of patients. General side-effects were reported by 10 patients and 6 were withdrawn. Poor local tolerance of the suppository was reported by 19 patients, 9 of whom stopped treatment.     

Section 2 Ibuprofen in the long-term treatment of coxarthrosis

Summary

In an open controlled trial of ibuprofen in the long-term treatment of osteoarthrosis of the hip, 35 patients received 1200?mg. ibuprofen daily over a period of 6 months. Seven patients discontinued treatment after 2 months because of remission of all symptoms and 7 others were withdrawn (2 due to side-effects, 5 for non-medical reasons). Subjective and objective assessments were carried out at monthly intervals. The results showed that pain was significantly reduced, particularly during the first 2 months, and there was a marked reduction in the need for additional analgesics. There was also a significant improvement in joint mobility within the first few months of treatment. Ibuprofen was well tolerated and side-effects were minimal.     

Section 1 The effect of ibuprofen on lymphocyte stimulation by phytohaemagglutillin in Vitro

Summary

A study was carried out to determine the effects of ibuprofen, phenylbutazone and indomethacin at different concentrations on phytohaemagglutinin-induced stimulation of lymphocytes in vitro. The results indicate that all three drugs inhibit lymphocyte stimulation, and at concentrations achieved by ibuprofen and phenylbutazone in vivo. It may be, therefore, that part of the effect of ibuprofen in rheumatoid arthritis is due to inhibition of lymphocyte function.