Double‐blind trial of flurbiprofen and phenylbutazone in acute gouty arthritis.

Rc, Butler; Goddard, D.L.H.; Higgens, C S; Hollingworth, P.; Pease, CT; Stodell, M. A.; Jp, Scott

doi:10.1111/j.1365-2125.1985.tb05110.x

Cited by 26 publications

(15 citation statements)

References 8 publications

(7 reference statements)

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“…Flurbiprofen (2-fluoro-α-methyl-4-biphenylacetic acid) is a representative 2-arylpropionic acid that can be used as a nonsteroidal anti-inflammatory drug (NSAID). Flurbiprofen (denoted hereafter as Fp) has been widely prescribed as an anti-inflammatory, antipyretic, and analgesic agent for several therapeutic applications such as pain from rheumatoid arthritis, − sunburn , and acute gout, migraine headache, , osteoarthritis, − soft tissue injuries (tendinitis and bursitis), , postoperative ocular inflammation (e.g., excimer laser photorefractive keratectomy), ,− vernal keratoconjunctivitis, ocular gingivitis, and herpetic stromal keratitis . Pharmacologically, Fp effects are mediated via inhibition of cyclooxygenase enzymes (COX-1 and COX-2, also referred to as prostaglandin H 2 synthases).…”

Section: Introductionmentioning

confidence: 99%

Time-Resolved Spectroscopic Characterization of a Novel Photodecarboxylation Reaction Mediated by Homolysis of a Carbon α-Bond in Flurbiprofen

Wong

et al. 2013

J. Phys. Chem. B

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Flurbiprofen (Fp), a nonsteroidal anti-inflammatory drug (NSAID) currently in use for arthritis pain relief and in clinical trials for metastatic prostate cancer, can induce photosensitization and phototoxicity upon exposure to sunlight. The mechanisms responsible for Fp phototoxicity are poorly understood and deserve investigation. In this study, the photodecarboxylation reaction of Fp, which has been assumed to underpin its photoinduced side effects, was explored by femtosecond transient absorption (fs-TA), nanosecond transient absorption (ns-TA), and nanosecond time-resolved resonance Raman (ns-TR(3)) spectroscopic techniques in pure acetonitrile (MeCN) solvent. Density functional theory (DFT) calculations were also performed to facilitate the assignments of transient species. The resonance Raman and DFT calculation results reveal that the neutral form of Fp was the predominant species present in MeCN. Analysis of the ultraviolet/visible absorption spectrum and results from TD-DFT calculations indicate that the second excited singlet (S2) can be excited by 266 nm light. Due to its intrinsic instability, S2 rapidly underwent internal conversion (IC) to decay to the lowest lying excited singlet (S1), which was observed in the fs-TA spectra at very early delay times. Intriguingly, three distinct pathways for S1 decay seem to coexist. Specifically, other than fluorescence emission back to the ground state and transformation to the lowest triplet state T1 through intersystem crossing (ISC), the homolysis of the carbon α-bond decarboxylation reaction proceeded simultaneously to give rise to two radical species, one being carboxyl and another being the residual, denoted as FpR. The coexistence of the triplet Fp (T1) and FpR species was verified by means of TR(3) spectra along with ns-TA spectra. As a consequence of its apparent high reactivity, the FpR intermediate was observed to undergo oxidation under oxygen-saturated conditions to yield another radical species, denoted as FOR, which subsequently underwent intramolecular hydrogen transfer (IHT) and dehydroxylation (DHO) to form a final product, which could react with the carboxyl from the decarboxylation reaction to generate a minor final product. TD-DFT and transient state (TS) calculations for predicting the absorption bands and activation energies of the transient species produced in the photodecarboxylation reaction have provided valuable mechanistic insights for the assignment of the intermediate species observed in the time-resolved spectroscopy experiments reported here. The results of the time-resolved spectroscopy experiments and DFT calculations were used to elucidate the reaction mechanisms and intermediates involved in the photochemistry of Fp.

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Section: Introductionmentioning

confidence: 99%

Time-Resolved Spectroscopic Characterization of a Novel Photodecarboxylation Reaction Mediated by Homolysis of a Carbon α-Bond in Flurbiprofen

Wong

et al. 2013

J. Phys. Chem. B

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“…21, The absolute risk for developing SAEs with AAD NSAID use was 2.3%. [32][33][34][35]37,39,41,[44][45][46][47]50,51,54 Interleukin (IL)-1 inhibitors are reported to be as effective as corticosteroids and NSAIDS for the treatment of acute gouty arthritis. 55 Unfortunately, these medicines are very expensive and are not widely available in many countries in the Asia-Pacific region.…”

Section: Among Patients With Acute Gouty Arthritis There Is Insufficient Evidence To Recommend For or Against The Use Of Intra-articular mentioning

confidence: 99%

2021 Asia‐Pacific League of Associations for Rheumatology clinical practice guideline for treatment of gout

et al. 2021

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Background: Gout is the most prevalent inflammatory arthritis in the Asia-Pacific region and worldwide. This clinical practice guideline (CPG) aims to provide recommendations based on systematically obtained evidence and values and preferences tailored to the unique needs of patients with gout and hyperuricemia in Asia, |LORENZO Et aL. | INTRODUC TI ONGout is the most prevalent inflammatory arthritis in the Asia-Pacific region and worldwide. 1 Its prevalence increased steadily in various countries: 2.7% in the 1990s to 3.9% in early 2000 in the United States and from 3.4 per 1000 in 2007 to 7.6 per 1000 persons in 2015 in Korea. 2,3 The prevalence is higher in certain ethnic groups.The risk for tophi formation tends to be higher after controlling for age, gender, hypertension, diuretic use, and kidney function. 4 Varying prevalence across ethnic groups indicates that genetics affects its development and the individual's risk when exposed to environmental or dietary variables. 5,6 Despite scientific advancements, disease control of gout is suboptimal. 2,3 Clinical practice guidelines (CPG) from Western and several Asian countries have provided recommendations for the management of gout. [7][8][9] However, the need to formulate unified Asia-Pacific recommendations was recognized. This CPG aims to provide evidence-based recommendations in managing gout in its different phases: asymptomatic hyperuricemia, acute gout, intercritical gout, and chronic tophaceous or complicated gout. It covers both pharmacologic and non-pharmacologic interventions (NPI) with consideration of the unique needs of patients with gout in Asia, Australasia, and the Middle East. The target users of these guidelines are general practitioners and specialists, including rheumatologists, in different clinical settings in these regions. | G UIDELINE DE VELOPMENT ME THODSThe Steering Committee (SC) formed the guideline development working groups (GDG), formulated the guideline questions (Table 1) in PICO (population, intervention, comparator, and outcome) format, and oversaw the CPG processes (Figure 1). The Technical Working Group (TWG) appraised and summarized the evidence, applied the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology to determine the certainty of evidence, and drafted the recommendations.The Consensus Panel (CP) was composed of 9 key stakeholders (rheumatologists, general practitioners, academicians, and a patient representative) from Australia,

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“…Although only a few open-label studies have reported quantitative results, nearly all have concluded clinical benefit associated with short-term NSAID therapy. Controlled studies have employed comparator groups that have included indomethacin [34][35][36][37], phenylbutazone [38][39][40][41][42][43], or a different dose of the study drug [44,45]. Although generally deemed beneficial with good tolerability, there have been no substantial differences between the study agents and comparator drugs.…”

Section: Nonsteroidal Anti-inflammatory Drugsmentioning

confidence: 99%

Gout treatment: What is evidence-based and how do we determine and promote optimized clinical care?

Mikuls

2005

Curr Rheumatol Rep

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Gout, a common form of inflammatory arthritis, has been markedly understudied relative to other rheumatologic conditions. As a result, evidence guiding clinical management in gout has traditionally been lacking. Burgeoning data suggests that quality of gout care in gout is frequently suboptimal. In this paper, we examine the evidence supporting gout management strategies in clinical practice. In addition, we examine consensus building efforts that have culminated in the recent publication of gout management quality indicators. We also discuss the need for future initiatives aimed at improving patient safety and quality of care in gout.

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Double‐blind trial of flurbiprofen and phenylbutazone in acute gouty arthritis.

Cited by 26 publications

References 8 publications

Time-Resolved Spectroscopic Characterization of a Novel Photodecarboxylation Reaction Mediated by Homolysis of a Carbon α-Bond in Flurbiprofen

Time-Resolved Spectroscopic Characterization of a Novel Photodecarboxylation Reaction Mediated by Homolysis of a Carbon α-Bond in Flurbiprofen

2021 Asia‐Pacific League of Associations for Rheumatology clinical practice guideline for treatment of gout

Gout treatment: What is evidence-based and how do we determine and promote optimized clinical care?

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