Comparative effects of aspirin and ibuprofen in the management of systemic lupus erythematosus

Karsh, Jacob; Kimberly, Robert P.; Stahl, Neil; Plötz, Paul H.; Decker, John L.

doi:10.1002/art.1780231215

Cited by 21 publications

(6 citation statements)

References 16 publications

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“…Nonsteroidal anti inflammatory drugs are often used, but therapeutic success may be limited by gastrointestinal, hepatic or renal toxicity. 2,3 The antimalarial drug, hydroxychloroquine, is often used to treat manifestations of mild to moderate SLE such as skin rash and joint pain. It is approved in the United States for treatment of SLE.…”

Section: Traditional Treatment For Slementioning

confidence: 99%

Bromocriptine treatment of systemic lupus erythematosus

Walker

2001

Lupus

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Prolactin, a peptide hormone, acts as a cytokine. It has been hypothesized that bromocriptine, a dopamine analog that suppresses pituitary secretion of prolactin, suppresses circulating prolactin and, through this mechanism, has the potential to suppress autoimmune disease. This rationale has been applied to the treatment of systemic lupus erythematosus (SLE), a prototype autoimmune illness that occurs spontaneously in animal models such as the F1 hybrid NZBxNZW mouse, and in humans. Treatment with bromocriptine was effective in treating some induced and spontaneous autoimmune disease in experimental models. Bromocriptine did slow the course of SLE in NZBxNZW mice when treatment was started before the appearance of clinical disease. In addition, bromocriptine was effective in treating established disease in this model. In three separate clinical trials, bromocriptine showed evidence that it had a therapeutic effect in treating human lupus. Bromocriptine is currently considered an unproven therapy for SLE. Its use is entirely experimental. The fact that bromocriptine was effective in treating NZBxNZW mice, the beneficial therapeutic effects in human trials, and the low toxicity of the drug form a solid rationale for undertaking further therapeutic trials.

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Section: Traditional Treatment For Slementioning

confidence: 99%

Bromocriptine treatment of systemic lupus erythematosus

Walker

2001

Lupus

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“…There have been well-documented cases of acute intersti tial nephritis often with heavy proteinuria of glomerular origin with fenoprofen, one of the phenylproprionate derivatives of this class of drugs [2][3][4]. Although renal functional impairment related to treatment with ibuprof en, another agent of similar chemical composition, has been reported on several occasions [5,8], in only one report were renal tissues examined; mild nonspecific tubular changes were observed [6], In contrast, we have studied renal biopsies from 2 patients with systemic lu pus gerythematosus who developed acute reversible renal failure temporally related to ibuprofen administration and have documented acute tubular necrosis in both. …”

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confidence: 99%

Ibuprofen-Induced Acute Renal Failure with Acute Tubular Necrosis

Fong¹,

Cohen²

1982

Am J Nephrol

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2 patients with systemic lupus erythematosus and mild renal functional impairment were treated with ibuprofen, one of the phenylproprionic nonsteroidal anti-inflammatory drugs. Within days after the onset of therapy, both developed renal insufficiency manifested by elevated serum creatinine levels, increased proteinuria, and active urinary sediments; 1 patient was oliguric. Renal biopsies disclosed mesangial proliferative lupus glomerulonephritis and acute tubular necrosis, the latter more pronounced in the oliguric patient. Renal failure resolved following discontinuation of ibuprofen and supportive therapy. It is postulated that altered blood flow, mediated through the well-known prostaglandin synthetase inhibitory effects of ibuprofen, resulted in tubular necrosis. This undesirable complication of ibuprofen therapy may be enhanced in patients with underlying renal disease, and may be a factor governing the limitation of its usage.

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“…In one pilot study, 50 SLE patients were followed for 8 months while openly being treated with celecoxib for musculoskeletal pain. There were no differences in the incidence of allergic reactions in patients with a self-reported history of sulfa allergy compared to those without such complaints [11].…”

Section: Dermatologicalmentioning

confidence: 71%

“…Seventeen patients completed the trial; seven of the nine on aspirin and two of eight on ibuprofen had dramatic improvement of swollen joints and joint pain. Two patients randomised to ibuprofen had decreases in creatinine clearance and an elevation in liver enzymes all of which reversed upon drug cessation [11].…”

Section: Clinical Efficacymentioning

confidence: 99%

Risk:benefit ratio of nonsteroidal anti-inflammatory drugs in systemic lupus erythematosus

Horizon¹,

Wallace²

2004

Expert Opinion on Drug Safety

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Nearly 80% of patients with systemic lupus erythematosus (SLE) are treated with NSAIDs for fever, arthritis, serositis and headaches. This article reviews currently available literature on non-selective and selective inhibitors of cyclooxygenases, with an emphasis on the efficacy and safety profile reported in SLE patients. All NSAIDs, regardless of their cyclooxygenase selectivity, induced renal side effects including sodium retention and reduction in glomerular filtration rate. In addition, lupus nephritis is a risk factor for NSAID-induced acute renal failure. NSAID-induced hepatotoxicity is increased in SLE patients in addition to cutaneous and allergic reactions. Finally, aseptic meningitis has been reported more frequently in NSAID-treated SLE patients. Nevertheless, NSAIDs can safely be prescribed to most lupus patients provided that their administration is re-evaluated on a regular basis and the patient is closely monitored.

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Comparative effects of aspirin and ibuprofen in the management of systemic lupus erythematosus

Cited by 21 publications

References 16 publications

Bromocriptine treatment of systemic lupus erythematosus

Bromocriptine treatment of systemic lupus erythematosus

Ibuprofen-Induced Acute Renal Failure with Acute Tubular Necrosis

Risk:benefit ratio of nonsteroidal anti-inflammatory drugs in systemic lupus erythematosus

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