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
目的研究硫酸氨基葡萄糖联合依托考昔治疗膝关节骨性关节炎的疗效以及安全性。方法将2013年9月至2014年9月于我院骨科门诊确诊为膝关节骨性关节炎的150例患者按随机数字表法分成依托考昔组、硫酸氨基葡萄糖组和联合组,每组50例,分别给...目的研究硫酸氨基葡萄糖联合依托考昔治疗膝关节骨性关节炎的疗效以及安全性。方法将2013年9月至2014年9月于我院骨科门诊确诊为膝关节骨性关节炎的150例患者按随机数字表法分成依托考昔组、硫酸氨基葡萄糖组和联合组,每组50例,分别给予依托考昔、硫酸氨基葡萄糖、两种药物联合用药治疗6周。于用药2周和6周时采用西安大略和麦克马斯特大学(the Western Ontario and Mc Master Universities,WOMAC)骨关节炎指数评估疗效并观察不良反应。结果 11例因不良反应退出试验,6例失访,最终133例完成试验且随访资料完整,其中依托考昔组44例,硫酸氨基葡萄糖组43例,联合组46例。治疗2周后,依托考昔组和联合组的WOMAC指数较治疗前有显著改善,其中联合组的改善优于依托考昔组(P<0.05);依托考昔组、硫酸氨基葡萄糖组、联合组的不良反应例数分别为2例、1例和2例。治疗6周后,3组患者的WOMAC指数均优于治疗前(均P<0.05),其中联合组优于依托考昔组和硫酸氨基葡萄糖组(P<0.05),硫酸氨基葡萄糖组优于依托考昔组(P<0.05);3组各发生2例不良反应。结论硫酸氨基葡萄糖联合依托考昔治疗膝关节骨性关节炎比单独使用依托考昔或硫酸氨基葡萄糖的疗效好、起效快,值得临床推广。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）.
文摘目的研究硫酸氨基葡萄糖联合依托考昔治疗膝关节骨性关节炎的疗效以及安全性。方法将2013年9月至2014年9月于我院骨科门诊确诊为膝关节骨性关节炎的150例患者按随机数字表法分成依托考昔组、硫酸氨基葡萄糖组和联合组,每组50例,分别给予依托考昔、硫酸氨基葡萄糖、两种药物联合用药治疗6周。于用药2周和6周时采用西安大略和麦克马斯特大学(the Western Ontario and Mc Master Universities,WOMAC)骨关节炎指数评估疗效并观察不良反应。结果 11例因不良反应退出试验,6例失访,最终133例完成试验且随访资料完整,其中依托考昔组44例,硫酸氨基葡萄糖组43例,联合组46例。治疗2周后,依托考昔组和联合组的WOMAC指数较治疗前有显著改善,其中联合组的改善优于依托考昔组(P<0.05);依托考昔组、硫酸氨基葡萄糖组、联合组的不良反应例数分别为2例、1例和2例。治疗6周后,3组患者的WOMAC指数均优于治疗前(均P<0.05),其中联合组优于依托考昔组和硫酸氨基葡萄糖组(P<0.05),硫酸氨基葡萄糖组优于依托考昔组(P<0.05);3组各发生2例不良反应。结论硫酸氨基葡萄糖联合依托考昔治疗膝关节骨性关节炎比单独使用依托考昔或硫酸氨基葡萄糖的疗效好、起效快,值得临床推广。
