Cyclooxygenase-2 Inhibitor for Pain Management in Osteoid Osteoma

Böttner, Friedrich; Roedl, Robert; Wörtler, Klaus; Grethen, Claude; Winkelmann, Winfried; Lindner, Norbert

doi:10.1097/00003086-200112000-00029

Cited by 41 publications

(30 citation statements)

References 39 publications

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“…Hence, the use of rofecoxib may be promising in such condition s (HPS/aBS, Gitelman R ofecoxib holds tremendous promise in treating and mitigating neurologica l ailments like hemicrania continua (Peres & Zukerman 2000;Peres & Silberstein 2002) and migraine (K rymchantowski & Barbosa 2002;Simitchieva et al 2002) and for pain management in osteoid osteoma (Bottner et al 2001).…”

Section: Future Prospectsmentioning

confidence: 99%

Rofecoxib: an update on physicochemical, pharmaceutical, pharmacodynamic and pharmacokinetic aspects

Ahuja

Singh

2003

Journal of Pharmacy and Pharmacology

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Rofecoxib (MK-966) is a new generation non-steroidal anti-inflammatory agent (NSAID) that exhibits promising anti-inflammatory, analgesic and antipyretic activity. It selectively inhibits cyclooxygenase (COX)-2 isoenzyme in a dose-dependent manner in man. No significant inhibition of COX-1 is observed with rofecoxib up to doses of 1000 mg. The pharmacokinetics of rofecoxib has been found to be complex and variable. Mean oral bioavailability after single dose of rofecoxib (12.5, 25 or 50 mg) is 93% with t m a x varying widely between 2 and 9 h. It is highly plasma-protein bound and is metabolized primarily by cytosolic reductases to inactive metabolites. Rofecoxib is eliminated predominantly by hepatic metabolism with a terminal half-life of approximately 17 h during steady state. Various experimental models and clinical studies have demonstrated rofecoxib to be superior, or at least equivalent, in anti-inflammatory, analgesic and antipyretic efficacy to comparator nonselective NSAIDs in osteoarthritis, rheumatoid arthritis and other pain models. Emerging evidence suggests that rofecoxib may also find potential use as supportive therapy in various pathophysiologic conditions like Alzheimer's disease, and in various malignant tumours and polyps, where COX-2 is overly expressed. Rofecoxib is generally well-tolerated. Analysis of data pooled from several trials suggests that rofecoxib is associated with fewer incidences of clinically symptomatic gastrointestinal ulcers and ulcer complications vis-a Á -vis conventional NSAIDs. However, this gastropreserving effect may be negated by concurrent use of low-dose aspirin for cardiovascular risk reduction. Rofecoxib tends to show similar tolerability for renal and cardiothrombotic events as compared with nonnaproxen nonselective NSAIDs. No clinically significant drug interaction has been reported for rofecoxib except with diuretics, where it reverses their salt-wasting effect and thus can be clinically exploited in electrolyte-wasting disorders. There is only modest information about the physicochemical and pharmaceutical aspects of rofecoxib. Being poorly water soluble, its drug delivery has been improved using varied formulation approaches. Although it is stable in solid state, rofecoxib is photosensitive and base-sensitive in solution form with its degradation mechanistics elucidated. Analytical determinations of rofecoxib and its metabolites in biological fluids employing HPLC with varied types of detectors have been reported. Isolated studies have also been published on the chromatographic and spectrophotometric assay of rofecoxib and its degradants in bulk samples and pharmaceutical dosage forms. The current article provides an updated overview on the physicochemical, pharmaceutical, pharmacokinetic and pharmacodynamic vistas of rofecoxib.

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Section: Future Prospectsmentioning

confidence: 99%

Rofecoxib: an update on physicochemical, pharmaceutical, pharmacodynamic and pharmacokinetic aspects

Ahuja

Singh

2003

Journal of Pharmacy and Pharmacology

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“…Einen zusätzlichen Beleg für die analgetische Wirksamkeit der Substanz liefert eine kürzlich publizierte deutsche Fallstudie an 13 Patienten mit OsteoidOsteom, einem benignen Knochentumor mit hohem Schmerzpotenzial [30]. Die Patienten wurden nacheinander zwei Tage nicht, dann vier Tage mit 3×500 mg ASS und schließlich zehn Tage mit 1×25 mg Rofecoxib behandelt.…”

Section: Schmerzstudien -Rofecoxibunclassified

Klinische Wirksamkeit der COX-2-Hemmer

Krüger¹

2002

Bundesgesundheitsbl - Gesundheitsforsch - Gesundheitsschutz

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Multiple studies in osteoarthritis (OA), rheumatoid arthritis (RA), and several acute pain models indicate that the cyclooxygenase-2-specific inhibitors celecoxib and rofecoxib are equally effective as the conventional nonsteroidal antirheumatic drugs diclofenac, ibuprofen, and naproxen. Both drugs are approved for the treatment of OA and RA in a daily dosage of 2×100 mg, 1×200 mg, and 2×200 mg (celecoxib) or 1×12.5 mg and 1×25 mg (rofecoxib). In addition, rofecoxib has also been approved by the FDA for the treatment of postsurgical pain in a dosage of 50 mg. Normally celecoxib is used in a dosage of 1×200 mg for OA and 2×200 mg for RA, whereas both 12.5 and 25 mg rofecoxib are used for the treatment of OA and 25 mg for the treatment of RA. Coxibs might also be used for the treatment of seronegative spondarthritides, as is indicated by a successful study using celecoxib for the treatment of ankylosing spondylitis.

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“…Pain is thought to be due to local inflammation and vasodilation, the consequence of very high levels of prostaglandins expressed by the tumors. The increased production of prostaglandins by osteoid osteomas implicates an enzyme, the cyclooxygenase-2 (COX-2), that is blocked by acetylsalicylic acid and rofecoxib [6][7]. Nerve fibers seen in the reactive zone around the nidus and/or in the nidus are also thought to play a key role in mediation of pain in osteoid osteoma [8][9].…”

Section: Introductionmentioning

confidence: 99%

CT-guided percutaneous laser photocoagulation of osteoid osteomas of the hands and feet

et al. 2008

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Percutaneous local ablation of osteoid osteoma has largely replaced surgery, except in the small bones of the hands and feet. The objective of this study was to describe the technical specificities and results of computed tomography (CT)-guided percutaneous laser photocoagulation in 15 patients with osteoid osteomas of the hands and feet. We retrospectively examined the medical charts of the 15 patients who were treated with CT-guided percutaneous laser photocoagulation therapy at our institution between 1994 and 2004. The 15 patients had a mean age of 24.33 years. None of them had received any prior surgical or percutaneous treatment for the osteoid osteoma. The follow-up period was 24 to 96 months (mean, 49.93). The pain resolved completely within 1 week. Fourteen patients remained symptom-free throughout the follow-up period; the remaining patient experienced a recurrence of pain after 24 months, underwent a second laser photocoagulation procedure, and was symptom-free at last follow-up 45 months later. No adverse events related to the procedure or to the location of the tumor in the hand or the foot were recorded. CT-guided percutaneous laser photocoagulation is an alternative to surgery for the treatment of osteoid osteomas of the hands and feet.

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Cyclooxygenase-2 Inhibitor for Pain Management in Osteoid Osteoma

Cited by 41 publications

References 39 publications

Rofecoxib: an update on physicochemical, pharmaceutical, pharmacodynamic and pharmacokinetic aspects

Rofecoxib: an update on physicochemical, pharmaceutical, pharmacodynamic and pharmacokinetic aspects

Klinische Wirksamkeit der COX-2-Hemmer

CT-guided percutaneous laser photocoagulation of osteoid osteomas of the hands and feet

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