Meaningful Relief with Flurbiprofen 8.75 mg Spray in Patients with Sore Throat due to Upper Respiratory Tract Infection

Looze, Ferdinandus de; Russo, Marc; Bloch, Mark; Montgomery, Barney; Shephard, Adrian; DeVito, Robert

doi:10.2217/pmt-2017-0100

Cited by 5 publications

(20 citation statements)

References 10 publications

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“…The previous findings were confirmed with flurbiprofen spray in a study by de Looze et al 33 Patients were required to report at least 30 min of "at least moderate" sore throat relief on the STRRS for the relief to be regarded as "clinically meaningful". Significantly more patients using flurbiprofen spray reported at least 30 min of "at least moderate" relief than those using placebo during the 6 h after a single dose (55% vs 35%, respectively; OR: 2.31; 95% CI: 1.61, 3.62; p<0.0001), and this was achieved more quickly with flurbiprofen than placebo (HR: 1.96; 95% CI: 1.50, 2.57; p<0.0001); 150 min for flurbiprofen and not calculated for placebo due to less than 50% response.…”

Section: Meaningful Pain Reliefmentioning

confidence: 81%

“…Fourteen papers reported data on the effectiveness of singledose flurbiprofen 8.75 mg for relieving throat pain and soreness; 17,22,25,26,[28][29][30][31][32][33][34][35]37,38 11 included data for flurbiprofen lozenges, four for flurbiprofen spray and one for flurbiprofen microgranules. In a study by Schachtel et al, 17 single-dose flurbiprofen lozenge demonstrated a significantly greater reduction (85%) in sore throat pain intensity summed over the 2 h post-dose period (as measured on the STPIS) compared with placebo (p<0.001).…”

Section: Single Dosementioning

confidence: 99%

“…Regarding absolute/percentage reductions in sore throat pain intensity/soreness from baseline, significantly greater reductions were observed with flurbiprofen vs placebo at all individual timepoints up to 2-4 h in several studies. 17,22,[29][30][31][32][33][34][35]37 Radkova et al 26 observed an STPIS pain intensity difference from baseline to 2 h post-dose of −40.51 and −40.10 with flurbiprofen spray and lozenges, respectively. No significant difference was observed between single-dose flurbiprofen spray and lozenge in terms of improvement in sore throat pain intensity.…”

Section: Single Dosementioning

confidence: 99%

“…44 Several of the studies included in this review have assessed "meaningful" pain relief with flurbiprofen. 17,18,33,35 Using a double stopwatch (DSW) method (Table 2), Schachtel et al 35 investigated both "first perceived" pain relief (the moment the patient experiences any pain relief, measured on the STPIS) and "meaningful" pain relief (when the patient experiences relief that is meaningful to them) with flurbiprofen lozenge. Results showed that 97% of flurbiprofentreated patients (n=101) experienced "first perceived" pain relief, with 78% achieving "meaningful" analgesia within the 3 h study period.…”

Section: Meaningful Pain Reliefmentioning

confidence: 99%

“…25,26 It is most commonly used at a dose of 8.75 mg, based on the results of a dose-ranging study that demonstrated linear dose-response relationships for effectiveness and adverse events at doses between 5.0 mg and 12.5 mg. 27 Its use for the symptomatic relief of pharyngitis of viral, bacterial, or unknown etiology has been assessed in a number of studies. 17,22,25,26,[28][29][30][31][32][33][34][35][36][37][38] It has also been evaluated for the relief of postoperative sore throat POST, [39][40][41] a common complication of general anesthesia 42 and tonsillectomy 43 that can negatively impact patients' postoperative comfort.…”

Section: Introductionmentioning

confidence: 99%

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<p>Locally Delivered Flurbiprofen 8.75 mg for Treatment and Prevention of Sore Throat: A Narrative Review of Clinical Studies</p>

Looze

Shephard

Smith

2019

JPR

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Background: Antibiotics are inappropriately prescribed to many people with sore throat. As most cases of sore throat are viral and/or self-limiting, guidelines recommend symptomatic management as first-line treatment. This paper reviews the available clinical evidence for the efficacy and safety of low-dose (8.75 mg) flurbiprofen, locally delivered to the throat for the symptomatic management of pharyngitis/sore throat. Method: A literature search was performed on 27 February 2019 using PubMed. Studies that met the following criteria were included in a narrative review: (1) studies evaluating the effectiveness of flurbiprofen for pharyngitis/sore throat; (2) randomized controlled studies; (3) locally administered formulation of study drug/comparator; and (4) flurbiprofen administered at 8.75 mg dose (single-or multiple-dose administration). Results: A total of 17 papers were included in the review: 15 publications reporting data from nine unique clinical studies of flurbiprofen for acute pharyngitis, and two reporting studies of flurbiprofen for the prevention of postoperative sore throat (POST). Studies in acute pharyngitis demonstrated that single-and multiple-dose flurbiprofen 8.75 mg, locally administered in lozenge, spray or microgranule form, was well tolerated and provided early onset and long-lasting symptomatic relief from throat pain and soreness, sensation of swollen throat, difficulty swallowing, and other associated symptoms. This included patients with more severe symptoms, patients with confirmed Streptococcus A/C sore throat, and patients taking concomitant antibiotics. In addition, a single preoperative dose of flurbiprofen lozenge was shown to be effective for relieving early POST in patients undergoing general anesthesia. Conclusion: Locally administered, low-dose flurbiprofen offers a useful first-line treatment option for symptomatic relief in patients with "uncomplicated" acute pharyngitis/sore throat associated with upper respiratory tract infection, thus potentially helping to reduce unnecessary antibiotic prescribing. It also offers an effective preoperative treatment option for the reduction of early POST severity and incidence.

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Section: Meaningful Pain Reliefmentioning

confidence: 81%

Section: Single Dosementioning

confidence: 99%

Section: Single Dosementioning

confidence: 99%

Section: Meaningful Pain Reliefmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

<p>Locally Delivered Flurbiprofen 8.75 mg for Treatment and Prevention of Sore Throat: A Narrative Review of Clinical Studies</p>

Looze

Shephard

Smith

2019

JPR

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Topical (local) antibiotics for respiratory infections with sore throat: An antibiotic stewardship perspective

Essack

Bell

Burgoyne³

et al. 2019

J Clin Pharm Ther

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What is known and objectiveThe overuse and misuse of antibiotics, especially for viral, and self‐limiting, respiratory tract infections such as sore throat, increases the risk of the development and spread of antimicrobial resistance within communities. Up to 80% of sore throat cases have a viral aetiology, and even when the infection is bacterial, most cases resolve without antibiotics. However, antibiotics are still frequently and often inappropriately prescribed for the treatment of sore throat. Furthermore, topical (local) antibiotics for treatment of sore throat are widely available over the counter. The objective of this systematic review was to establish the evidence for the benefits, risk of harm and antimicrobial resistance associated with topical (local) antibiotics used for patients with sore throat.MethodsEligible studies included those in patients with sore throat of any aetiology receiving the topical (local) antibiotics tyrothricin, bacitracin, gramicidin or neomycin where the antibiotic was topically/locally applied via the nasal cavity or throat. Nasal applications were included as these are occasionally used to treat upper respiratory tract infections that may involve sore throat. There was no restriction or requirement regarding comparator. The outcomes of interest included efficacy, safety, and in vitro culture and antimicrobial resistance data.Results and discussionThis systematic review found sparse and mainly poor‐quality evidence relating to the use of topical (local) antibiotics for sore throat, and it was not possible to establish the benefits, risk of harm or impact of use on antimicrobial resistance.What is new and conclusionsFurther research is necessary to ascertain the risks and benefits of topical (local) antibiotics, their contribution to antimicrobial resistance and the risk of harm. We do, however, question whether it is appropriate and rational to use topical (local) antibiotics for the treatment of sore throat caused by respiratory tract infections in the absence of robust evidence.

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Penetration of Flurbiprofen from a Locally Applied Sore Throat Lozenge and Spray into Cadaveric Human Pharynx Tissue: A Novel ex vivo Model and Microautoradiography Method

Turner¹,

Wevrett²,

Edmunds³

et al. 2021

CPAA

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Objective: Flurbiprofen 8.75 mg lozenge and spray are used for symptomatic relief of sore throat, with a rapid onset of analgesia suggesting a localized mechanism of action. Building on previous studies, this investigation aimed to use microautoradiography to visualize the depth penetration of radiolabeled flurbiprofen into human pharynx tissue using an ex vivo model. Quantification of flurbiprofen in the tissue was performed to provide a quantitative representation of flurbiprofen distribution through the tissue. Methods: Cadaveric human pharynx tissue was mounted between the donor and receiver compartments of a Franz diffusion cell. After that 8.75 mg spray and dissolved lozenge formulations, containing radiolabeled flurbiprofen, were added to the donor compartment of a Franz diffusion cell. After incubation for one hour, the pharynx tissue was removed, processed, and sectioned both horizontally and vertically. The sections were placed within an imaging cassette to determine the penetration of radiolabeled flurbiprofen visually, before being solubilized to quantify the amount of flurbiprofen present in each section. Results: In the horizontally sectioned samples, flurbiprofen was present in the top layers of all replicates and decreased in intensity throughout the tissue. Of the applied dose, 48.0--99.9% of flurbiprofen was detected in the top one-third of the pharynx tissue, closest to the dosing site, and 0-14.8% of flurbiprofen was detected within the deepest third of pharynx tissue, furthest from the dosing site. In the vertically sectioned tissue samples, radiolabeled flurbiprofen was found at a high intensity at the dosing site and reduced in intensity throughout the thickness of the tissue. Lateral penetration of flurbiprofen was also seen in tissue dosed with the spray. Conclusion:Our findings demonstrate that lozenge and spray formulations of flurbiprofen can penetrate throughout the layers of cadaveric human pharynx tissue in an ex vivo model, as visualized by microautoradiography.

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Meaningful Relief with Flurbiprofen 8.75 mg Spray in Patients with Sore Throat due to Upper Respiratory Tract Infection

Abstract: Flurbiprofen spray provides rapid, long-lasting and clinically meaningful relief from sore throat (ANZCTR: ACTRN12612000457842).

Cited by 5 publications

References 10 publications

<p>Locally Delivered Flurbiprofen 8.75 mg for Treatment and Prevention of Sore Throat: A Narrative Review of Clinical Studies</p>

<p>Locally Delivered Flurbiprofen 8.75 mg for Treatment and Prevention of Sore Throat: A Narrative Review of Clinical Studies</p>

Topical (local) antibiotics for respiratory infections with sore throat: An antibiotic stewardship perspective

Penetration of Flurbiprofen from a Locally Applied Sore Throat Lozenge and Spray into Cadaveric Human Pharynx Tissue: A Novel ex vivo Model and Microautoradiography Method

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