Efficacy and safety of lornoxicam in the treatment of acute and chronic pain

November 4, 2022
1185
Resume

The modern concept of successful treatment of patients with acute and chronic pain involves a rational approach to nonsteroidal anti-inflammatory drugs (NSAIDs) selection, which is based on the use of drugs with a pronounced analgesic effect and a good safety profile, which will allow to achieve the desired treatment effect. The purpose of this review was to analyze data from literary sources regarding the effectiveness and safety of using lornoxicam in patients with acute and chronic pain compared to other NSAIDs. The results of the data of literature analysis indicated that lornoxicam was an equivalent or more effective drug in renal colic and acute low back pain treatment, reducing the severity of pain in patients with rheumatic diseases and in postoperative period compared to other NSAIDs (diclofenac, rofecoxib, ibuprofen). In addition, the use of lornoxicam was accompanied by good tolerability among patients, which is associated with the pharmacological features of the drug. Therefore, lornoxicam is a modern high effective drug with a strong analgesic effect and a low risk of the development of gastrointestinal adverse events.

References

  • 1. Phillips W.J., Currier B.L. (2004) Analgesic pharmacology: II. Specific analgesics. J. Am. Acad. Orthop. Surg., 12(4): 221–233.
  • 2. Vane J.R. (1971) Inhibition of prostaglandin synthesis as a mechanism of action for aspirin-like drugs. Nat. New. Biol., 231(25): 232–235.
  • 3. Berg J., Christoph T., Widerna M. et al. (1997) Isoenzyme specific cyclooxygenase inhibitors: A whole cell assay system using the human erythroleukemic cell line HEL and the human monocytic cell line MonoMac6. J. Pharmacol. Toxicol., 37: 179–186.
  • 4. Xu S., Rouzer C.A., Marnett L.J. (2014) Oxicams, a class of nonsteroidal anti‐inflammatory drugs and beyond. IUBMB life, 66(12): 803–811. DOI: 10.1074/jbc.M113.517987.
  • 5. Ahmed M.O., Al-Badr A.A. (2011) Lornoxicam. Profiles Drug Subst. Excip. Relet. Methodol., 36: 205–239. DOI: 10.1016/B978-0-12-387667-6.00006-3.
  • 6. Berg J., Fellier H., Christoph T. et al. (1999) The analgesic NSAID lornoxicam inhibits cyclooxygenase (COX)-1/-2, inducible nitric oxide synthase (iNOS), and the formation of interleukin (IL)-6 in vitro. Inflamm. Res., 48(7): 369–379. DOI: 10.1007/s000110050474.
  • 7. Цурко В., Хитров Н., Агапова Л. (2005) Клиническая оценка внутрисуставного введения лорноксикама (ксефокама) у больных ревматоидным гонартритом. Практич. мед., 1(10): 62–63.
  • 8. Temeltas G., Asan C., Muezzinoglu T. et al. (2008) An Evaluation of the Efficacy of Lornoxicam in Acute Renal Colic Treatment. Üniversitesi Tıp Fakültesi Dergisi, 15(1): 1–3.
  • 9. Yakhno N., Guekht A., Skoromets A. et al. (2006) Analgesic efficacy and safety of lornoxicam quick-release formulation compared with diclofenac potassium: randomised, double-blind trial in acute low back pain. Clin. Drug Investig., 26(5): 267–277. DOI: 10.2165/00044011-200626050-00004.
  • 10. Herrmann W.A., Geertsen M.S. (2009) Efficacy and safety of lornoxicam compared with placebo and diclofenac in acute sciatica/lumbo-sciatica: an analysis from a randomised, double-blind, multicentre, parallel-group study. Int. J. Clin. Pract., 63(11): 1613–1621. DOI: 10.1111/j.1742-1241.2009.02187.x.
  • 11. Caruso I., Montrone F., Boari L. et al. (1994) Lornoxicam versus diclofenac in rheumatoid arthritis: a double-blind, multicenter study. Adv. Ther., 11(3): 132–138.
  • 12. Kidd B., Frenzel W. (1996) A multicenter, randomized, double blind study comparing lornoxicam with diclofenac in osteoarthritis. J. Rheumatol., 23(9): 1605–1611.
  • 13. Goregaonkar A., Mathiazhagan K.J., Shah R.R. et al. (2009) Comparative assessment of the effectiveness and tolerability of lornoxicam 8 mg BID and diclofenac 50 mg TID in adult indian patients with osteoarthritis of the hip or knee: a 4-week, double-blind, randomized, comparative, multicenter study. Curr. Ther. Res. Clin. Exp., 70(1): 56–68. DOI: 10.1016/j.curtheres.2009.02.006.
  • 14. Rose P., Steinhauser C. (2004) Comparison of Lornoxicam and Rofecoxib in Patients with Activated Osteoarthritis (COLOR Study). Clin. Drug Investig., 24(4): 227–236. DOI: 10.2165/00044011-200424040-00004.
  • 15. Головач I.Ю., Чіпко Т.М., Лазоренко О.О. (2013) Ефективність внутршіньосуглобового введення лорноксикаму у пацієнтів зі синовііїтом колінних суглобів. Укр. ревм. журн., 3(53): 113–114.
  • 16. Das S.K., Banerjee M., Mondal S. et al. (2013) A comparative study of efficacy and safety of lornoxicam versus tramadol as analgesics after surgery on head and neck. Indian J. Otolaryngol. Head Neck Surg., 65(Suppl. 1): 126–130. DOI: 10.1007/s12070-013-0617-y.
  • 17. Yücel A., Yazıcı A., Müderris T. et al. (2016) Comparison of lornoxicam and low-dose tramadol for management of post-thyroidectomy pain. Agri, 28(4): 183–189. DOI: 10.5505/agri.2016.94546.
  • 18. Страфун С.С., Вовченко Г.Я., Страфун О.С. (2010) Застосування лорноксикаму в комплексному лікуванні післяопераційного больового синдрому в пацієнтів, що зазнали артроскопічних оперативних втручань на колінних суглобах. Здоров’я України, 17: 1–3.
  • 19. Martinez L., Ekman E., Nakhla N. (2019) Perioperative Opioid-sparing Strategies: Utility of Conventional NSAIDs in Adults. Clin. Ther., 41(12): 2612–2628. DOI: 10.1016/j.clinthera.2019.10.002.
  • 20. Hall P.E., Derry S., Moore R.A. et al. (2009) Single dose oral lornoxicam for acute postoperative pain in adults. Cochrane Database Syst. Rev., 4: CD007441. DOI: 10.1002/14651858.CD007441.pub2.
  • 21. Varsha G.J., Nimesh P.A., Dave B.R. et al. (2013) A comparison of the efficacy and tolerability of lornoxicam and diclofenac sodium in patients with acute postoperative pain after spinal surgery. Am. J. Phytomed. Clin. Therap., 1(5): 507–515.
  • 22. Isola G., Alibrandi A., Pedullа E. et al. (2019) Analysis of the Effectiveness of Lornoxicam and Flurbiprofen on Management of Pain and Sequelae Following Third Molar Surgery: A Randomized, Controlled, Clinical Trial. J. Clin. Med., 8(3): 325. DOI: 10.3390/ jcm8030325.
  • 23. Parada L., Marstein J.P., Danilov A. (2016) Tolerability of the COX-1/COX-2 inhibitor lornoxicam in the treatment of acute and rheumatic pain. Pain Management, 6(5): 445–454.
  • 24. Pleiner J., Nell G., Branebjerg P.E. et al. (2009) Safety of lornoxicam: an interim meta-analysis of comparative clinical trials. Eur. J. Pain, 13(Suppl. 1): 191. DOI: 10.1016/ S1090-3801 (09)60662-5.
  • 25. Arfe A., Scotti L., Varas-Lorenzo C. et al. (2016) Non-steroidal anti-inflammatory drugs and risk of heart failure in four European countries: nested case-control study. BMJ, 354: i4857. DOI: 10.1136/bmj.i4857.
  • 26. Schink T., Kollhorst B., Varas Lorenzo C. et al. (2018) Risk of ischemic stroke and the use of individual non-steroidal anti-inflammatory drugs: a multi-country European database study within the SOS Project. PLoS One, 13(9): e0203362. DOI: 10.1371/ journal.pone.0203362.