Meloxicam in rheumatoid arthritis.
Meloxicam in rheumatoid arthritis.
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DOI：
10.1517/17425255.1.4.739
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发表时间：
2005-12-01
影响因子：
4.3
通讯作者：
Furst, Daniel E
中科院分区：
文献类型：
--
作者：
Ahmed, Mansoor;Khanna, Dinesh;Furst, Daniel E
类风湿关节炎(RA)是一种以关节疼痛、僵硬、肿胀和多系统受累为特征的慢性炎症性多系统疾病，需要多方面的治疗方法。它包括使用镇痛剂进行对症治疗，以及随着时间的推移改变类风湿性关节炎的病程的疾病修正药物。非甾体抗炎药因其症状效应而被广泛使用，但它们的使用也不是没有副作用，其中可能包括威胁生命的不良事件，如胃肠道出血和穿孔。美洛昔康是一种非甾体抗炎药的烯醇酸类化合物，最近已被美国FDA批准用于类风湿性关节炎和骨关节炎。在FDA推荐的剂量下，美洛昔康优先使用COX-2。由于COX-2的这种优先活性，与COX-2非选择性NSAIDs相比，它的胃肠道毒性有望更低。临床试验表明，每天7.5-15毫克的美洛昔康在抗炎和止痛方面与双氯芬酸、吡罗昔康和萘普生一样有效，而且与较少的胃肠道不良反应有关。
Rheumatoid arthritis (RA), a chronic inflammatory multisystem disorder marked by joint pain, stiffness, swelling and multiple systemic involvements, requires a multifaceted approach for its management. It includes symptomatic treatment with analgesics as well as disease-modifying medications to alter the course of RA over time. NSAIDS have been widely used for their symptomatic effects, but their use is not free from adverse effects, which may include life-threatening adverse events such as gastrointestinal (GI) bleeding and perforation. Meloxicam, an oxicam derivative that is a member of the enolic acid group of NSAIDs, has recently been approved by the US FDA for use in RA and osteoarthritis. At the FDA-recommended doses meloxicam is COX-2 preferential. By virtue of this COX-2 preferential activity it is expected to have lower GI toxicity as compared with COX-2 nonselective NSAIDs. Clinical trials have shown that meloxicam at 7.5 - 15 mg/day is as effective as diclofenac, piroxicam and naproxen as an anti-inflammatory and analgesic, and was associated with fewer GI adverse effects.