Background： DIIHA （Drug-induced immune hemolytic anemia） is rare, and a specialized laboratory is often required to provide optimal serological tests to confirm diagnosis. There have been few cases reported of etor...Background： DIIHA （Drug-induced immune hemolytic anemia） is rare, and a specialized laboratory is often required to provide optimal serological tests to confirm diagnosis. There have been few cases reported of etoricoxib-induced immune hemolytic anemia. Immune complexes formed between some drugs and their respective antibodies attach weakly or strongly in a nonspecific way to RBCs （red blood cells）. The bound immune complex activates complement, which may lead to hemolysis in vivo. Aims： Demonstration of immune complex formation involving etoricoxib in vitro. Methods： A 46-year-old woman developed acute severe anemia one day after a single dose of etoricoxib 90 mgper os with a strong positive DAT （direct anti-globulin test） and a weak positive IAT （indirect anti-globuline test）. For investigation diagnosis, we used the American Association of Blood Banks Technical Manual protocol using patient serum collected in three different moments （at patient admission, one month after and one month after stopping steroids）. Results： The authors found strong positive IAT reactions when the patient serum was tested with the drug. Conclusions： The strong agglutination that occurred in the mixture of the drug and the patient serum indicates a drug/antidrug interaction and may lead to DIIHA. This was the first case reported in Portugal of DIIHA induced by etoricoxib.展开更多
Background Acute gout is an intensely painful, inflammatory arthritis. Although the non-steroidal anti-inflammatory drugs （NSAIDs） are widely used for this condition, the efficacy is based on only a few studies, par...Background Acute gout is an intensely painful, inflammatory arthritis. Although the non-steroidal anti-inflammatory drugs （NSAIDs） are widely used for this condition, the efficacy is based on only a few studies, particularly in China. We tried to assess the safety and efficacy of etoricoxib in the treatment of acute gouty arthritis in China. Methods A randomized, double-blind, active comparator study was conducted at 10 sites in China. Patients （n=178; 〉18 years of age） with acute gouty attack （〈48 hours） were treated for 5 days with etoricoxib （120 mg/d; n=89） or indometacin （75 mg twice daily; n=89）. The primary efficacy end point was self-assessed pain in the affected joint （0-4 point Likert scale） from days 2-5. Secondary end points included investigator assessments of tenderness and swelling, patient/ investigator global assessments of response to therapy, and patients discontinuing treatment. Safety was assessed by adverse events （AEs）. Results Etoricoxib and indometacin had comparable primary and secondary end points. Mean change difference from baseline from days 2-5 was 0.03 （95% confidence interval （CI） -0.19 to 0.25; P=0.6364）, which fell within the prespecifled comparative bounds of -0.5 to 0.5. No severe AEs were associated with etoricoxib use. Non-severe AEs were mainly digestive and general, and most （73.7%） were mild, although they caused withdrawal of two subjects in the etoricoxib group, due to bilateral renal calculi and uronephrosis of the left kidney （unrelated to etoricoxib） and fever and chills （potentially etoricoxib-related）. Overall, AEs were similar, although the absolute number of AEs in the etoricoxib group （n=31） was less than the indometacin group （n=34）. Conclusions Etoricoxib （120 mg once daily） is effective in treating acute gout, is generally safe and well-tolerated, and is comparable in efficacy to indometacin （75 mg twice daily）.展开更多
1例67岁男性患者,既往无高血压病史,因可疑痛风发作自2021年4月29日起口服依托考昔片(60 mg,qd)、碳酸氢钠片(1 g,tid),外用双氯芬酸钠二乙胺乳胶剂治疗。5月2日患者出现头晕,伴胸闷,自测血压180/90 mm Hg,服用苯磺酸氨氯地平片2.5 mg...1例67岁男性患者,既往无高血压病史,因可疑痛风发作自2021年4月29日起口服依托考昔片(60 mg,qd)、碳酸氢钠片(1 g,tid),外用双氯芬酸钠二乙胺乳胶剂治疗。5月2日患者出现头晕,伴胸闷,自测血压180/90 mm Hg,服用苯磺酸氨氯地平片2.5 mg后复测收缩压降至150 mm Hg,头晕、胸闷等症状较前改善。5月3日患者晨起再次出现头晕发作,自测血压204/101 mm Hg,就诊于急诊予以对症降压治疗后好转,嘱停用依托考昔片。5月4–7日患者血压波动于130~150/70~80 mm Hg,头晕间断发作,未服药治疗。5月8日患者晨起后再次出现头晕发作,自测血压190/90 mm Hg,加服苯磺酸氨氯地平片5 mg后就诊于心内科。入院经各项检查排除原发疾病影响,未予降压治疗,1 d后患者血压恢复正常,准予出院。展开更多
文摘Background： DIIHA （Drug-induced immune hemolytic anemia） is rare, and a specialized laboratory is often required to provide optimal serological tests to confirm diagnosis. There have been few cases reported of etoricoxib-induced immune hemolytic anemia. Immune complexes formed between some drugs and their respective antibodies attach weakly or strongly in a nonspecific way to RBCs （red blood cells）. The bound immune complex activates complement, which may lead to hemolysis in vivo. Aims： Demonstration of immune complex formation involving etoricoxib in vitro. Methods： A 46-year-old woman developed acute severe anemia one day after a single dose of etoricoxib 90 mgper os with a strong positive DAT （direct anti-globulin test） and a weak positive IAT （indirect anti-globuline test）. For investigation diagnosis, we used the American Association of Blood Banks Technical Manual protocol using patient serum collected in three different moments （at patient admission, one month after and one month after stopping steroids）. Results： The authors found strong positive IAT reactions when the patient serum was tested with the drug. Conclusions： The strong agglutination that occurred in the mixture of the drug and the patient serum indicates a drug/antidrug interaction and may lead to DIIHA. This was the first case reported in Portugal of DIIHA induced by etoricoxib.
文摘Background Acute gout is an intensely painful, inflammatory arthritis. Although the non-steroidal anti-inflammatory drugs （NSAIDs） are widely used for this condition, the efficacy is based on only a few studies, particularly in China. We tried to assess the safety and efficacy of etoricoxib in the treatment of acute gouty arthritis in China. Methods A randomized, double-blind, active comparator study was conducted at 10 sites in China. Patients （n=178; 〉18 years of age） with acute gouty attack （〈48 hours） were treated for 5 days with etoricoxib （120 mg/d; n=89） or indometacin （75 mg twice daily; n=89）. The primary efficacy end point was self-assessed pain in the affected joint （0-4 point Likert scale） from days 2-5. Secondary end points included investigator assessments of tenderness and swelling, patient/ investigator global assessments of response to therapy, and patients discontinuing treatment. Safety was assessed by adverse events （AEs）. Results Etoricoxib and indometacin had comparable primary and secondary end points. Mean change difference from baseline from days 2-5 was 0.03 （95% confidence interval （CI） -0.19 to 0.25; P=0.6364）, which fell within the prespecifled comparative bounds of -0.5 to 0.5. No severe AEs were associated with etoricoxib use. Non-severe AEs were mainly digestive and general, and most （73.7%） were mild, although they caused withdrawal of two subjects in the etoricoxib group, due to bilateral renal calculi and uronephrosis of the left kidney （unrelated to etoricoxib） and fever and chills （potentially etoricoxib-related）. Overall, AEs were similar, although the absolute number of AEs in the etoricoxib group （n=31） was less than the indometacin group （n=34）. Conclusions Etoricoxib （120 mg once daily） is effective in treating acute gout, is generally safe and well-tolerated, and is comparable in efficacy to indometacin （75 mg twice daily）.
文摘1例67岁男性患者,既往无高血压病史,因可疑痛风发作自2021年4月29日起口服依托考昔片(60 mg,qd)、碳酸氢钠片(1 g,tid),外用双氯芬酸钠二乙胺乳胶剂治疗。5月2日患者出现头晕,伴胸闷,自测血压180/90 mm Hg,服用苯磺酸氨氯地平片2.5 mg后复测收缩压降至150 mm Hg,头晕、胸闷等症状较前改善。5月3日患者晨起再次出现头晕发作,自测血压204/101 mm Hg,就诊于急诊予以对症降压治疗后好转,嘱停用依托考昔片。5月4–7日患者血压波动于130~150/70~80 mm Hg,头晕间断发作,未服药治疗。5月8日患者晨起后再次出现头晕发作,自测血压190/90 mm Hg,加服苯磺酸氨氯地平片5 mg后就诊于心内科。入院经各项检查排除原发疾病影响,未予降压治疗,1 d后患者血压恢复正常,准予出院。
