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Biomedical subjects

V Wright

Publications and source records attributed to V Wright.

At least 163 records · Page 9Linked to original sources
PubMed1985

Single and multiple oral dose pharmacokinetics of tenoxicam in the elderly.

Tenoxicam is a new non-steroidal anti-inflammatory drug with a long half-life. Since such drugs may be particularly prone to accumulate in elderly patients, a group of the population in which anti-inflammatory agents are most commonly prescribed, we have studied the pharmacokinetics of tenoxicam in 18 patients (age range 62-87 years) with osteoarthrosis or rheumatoid arthritis. A pharmacokinetic profile was performed after a single 20 mg oral dose. Patients then took regular medication until they had reached steady-state for chronic dosing (20 mg/day) when a further pharmacokinetic profile was performed. Approximately five-fold accumulation was found at steady-state (mean peak plasma level 2.6 micrograms/ml for a single dose against 12.4 micrograms/ml at steady-state). Twenty percent of the dose was eliminated in the first dose interval. Mean pre-dose plasma level at steady-state was 9.6 micrograms/ml with a coefficient of variation of 11%. Serial haematological and biochemical estimations during the study showed no evidence of drug toxicity.

Administration, Oral↗
PubMed1985

A double-blind parallel study of tenoxicam and piroxicam in patients with osteoarthrosis.

Tenoxicam (TILCOTIL, MOBIFLEX) 40 mg/day has been compared to piroxicam 40 mg/day in a double-blind, parallel group study of 4 weeks duration in 30 patients with osteoarthrosis. Both drugs were well tolerated, tenoxicam slightly better than piroxicam. Both drugs improved general pain, improvement being greater with tenoxicam. Little improvement of other symptoms was seen with either treatment. At the end of the study, 12 tenoxicam-treated patients and seven piroxicam-treated patients elected to remain on their respective treatment.

Adult↗
PubMed1984

Captopril: a new treatment for rheumatoid arthritis?

Captopril, an inhibitor of angiotensin converting enzyme, is prescribed for hypertension. Its molecular structure shares features with D-penicillamine, in that both agents contain a thiol group. In addition, captopril has immunosuppressant activity. Captopril was therefore considered a potential slow-acting drug for treating rheumatoid arthritis. In an open study 15 patients with active arthritis were treated with captopril and followed for 48 weeks. Two-thirds of the patients reported improved arthritis symptoms, and significant changes were seen in several clinical and biochemical measurements, notably Ritchie articular index, clinical score, plasma viscosity, and C-reactive protein. Side-effects were generally mild and included transient taste loss, rashes, and hypotension. Only 2 patients withdrew as a result of drug intolerance.

Adult↗
PubMed1984

Comparison of 12 different containers for dispensing anti-inflammatory drugs.

Twelve containers manufactured by 10 pharmaceutical companies for dispensing anti-inflammatory drugs, 10 of which are currently in use in the United Kingdom, have been compared in 99 patients with arthritis of the hands. Patients were given the containers in random order and were asked to open them, extract the tablets, and close them. Patients were questioned on ease of handling at each stage and were then timed on reopening and closing each container. Finally, the patients were asked which container was the best and which was the worst. There was a wide variation in popularity of containers. One was judged outstanding on almost every attribute, and four were preferred over the others on most attributes. A successful container for arthritic hands is likely to have a sharply angulated or "wing" cap placed on a tall slim base that is also angulated. Flip off tops, tops with long threads requiring many turns, very small containers, and glass were regarded as unfavourable. Manufacturers should take note of these findings and, where necessary, consider redesigning the containers.

Adult↗
PubMed1984

A comparison of therapies which may influence trace metals in rheumatoid arthritis.

Forty-five patients with active rheumatoid arthritis (RA) were treated with D-Penicillamine (DPA), zinc sulphate or trien for 24 weeks. Clinical and biochemical assessments were made on eight occasions during the treatment period. Results supported the view that DPA is efficacious causing both clinical and biochemical improvement, whereas zinc sulphate provided clinical benefit in some patients without improving the biochemistry, and trien was ineffective in both respects. The results indicate the need for more thorough investigations of the effect of drugs on trace metal distribution in RA.

Arthritis, Rheumatoid↗
PubMed1984

A single-blind comparative study of auranofin and hydroxychloroquine in patients with rheumatoid arthritis.

Forty patients with rheumatoid arthritis were randomly allocated to treatment with auranofin 3 mg b.d. or hydroxychloroquine 200 mg b.d. Twenty patients received each drug. Efficacy was analysed by comparing patients with available data at weeks 12, 24, 36 and 48 with baseline within each treatment group, and between treatment groups at each of these same time points. There were statistically significant improvements in all measured parameters of clinical efficacy among hydroxychloroquine treated patients, and in all efficacy parameters except one (time to onset of fatigue) in the auranofin treatment group. There were no significant differences between the treatment groups for any parameter of clinical efficacy. Of the laboratory parameters measured, only auranofin treatment produced statistically significant decreases in the concentration of IgA, IgG and IgM, with significant differences between treatments being detected in the case of IgA and IgG. Eight auranofin-treated and three hydroxychloroquine-treated patients were withdrawn because of adverse reactions before completing 48 weeks treatment. The commonest reason for stopping auranofin treatment was diarrhoea (5 cases). Three hydroxychloroquine-treated and two auranofin-treated patients were withdrawn from the study because of inefficacy of the trial drug. Auranofin had a more 'potent' biochemical profile than hydroxychloroquine, although more patients tolerated one year of treatment with the latter drug.

Adult↗
PubMed1984

Forces in the knee joint whilst rising from a seated position.

Knee joint forces were determined by kinesiological techniques, using a high speed cine camera, a force platform, a specially constructed dynamometerized chair, and EMG recorders; so that a comparison could be made for rising from a normal chair with and without the aid of arms, and for rising from high and low chairs. For rising from the seated position, the knee joint forces parallel to the long axis of the tibia at the point of contact between the tibia and femur were found to be up to seven times body weight at about the time when the body left contact with the chair. When rising from a chair with the aid of arms, the knee joint forces were reduced to less than three times body weight. Knee joint and muscle forces were also reduced when rising from a high seat compared with rising from a low seat.

Biomechanical Phenomena↗
PubMed1984

Use of electromyography to study leg muscle activity in patients with arthritis and in normal subjects during rising from a chair.

A previous study indicated the need for patients with arthritis to have an armchair from which it is easy to rise. To determine criteria for such a chair a greater understanding of the rising activity and the objective assessment of chair design is required. The major muscle groups of the leg were monitored by electromyography (EMG) in normal subjects and for patients with arthritis during rising from a chair. The effects on EMG patterns of changes of seat height, foot position, and the use of armrests were studied. This paper outlines the practical difficulties that must be borne in mind when designing an EMG study on arthritic and elderly subjects. The results did not illustrate any differences in the pattern of muscle activity between arthritic and normal subjects, nor did they show any differences caused by changing the variables of chair design.

Arthritis↗
PubMed1984

Attempt to modify klebsiella carriage in ankylosing spondylitic patients by diet: correlation of klebsiella carriage with disease activity.

Patients with ankylosing spondylitis were asked to follow a 'klebsiella exclusion diet' for 5 months of a 10-month study. The same percentage of faecal samples were positive for klebsiella whether the patients were on or off the experimental diet. The diet also failed to influence variability of klebsiella serotypes. We found no correlation between acquisition of klebsiella and deterioration of disease symptoms, as recorded by the patients. Furthermore, carriage of klebsiella did not correlate with any of the following parameters of disease activity measured in the outpatient clinic: morning stiffness, pain measured on a visual analogue scale, analgesic consumption, ESR, total serum IgA. We found no evidence, therefore, that faecal klebsiella is involved in disease exacerbations of ankylosing spondylitis.

Adult↗
PubMed1984

An assessment of faecal blood loss from Ro 21-5521, a novel non-steroidal anti-inflammatory agent, in normal volunteers.

Faecal blood loss arising from Ro 21-5521, a novel non-steroidal anti-inflammatory agent with a long plasma half-life of about 41 hours, was evaluated in a double-blind crossover study against matched placebo in 12 volunteers. After a 1-week run-in period to determine baseline values, subjects were allocated at random to receive either 250 mg Ro 21-5521 per day or placebo for 2 weeks before being crossed over to the alternative treatment for 2 weeks. They were then followed-up for a further 2 weeks. Blood loss was calculated from 51Chromium tagged red blood cells in stools collected for a 96-hour period during each week of the study. Plasma levels of Ro 21-5521 were also measured twice weekly throughout the study. The results showed that with a drug of this long half-life, faecal blood loss may continue for at least 4 weeks after cessation of trial therapy of 2 weeks. It is recommended that in the evaluation of faecal blood loss resulting from drugs with a long half-life, a parallel group study, each group receiving only one drug (or one drug crossed against placebo), is the study design of choice.

Adult↗
PubMed1984

C-reactive protein in the serial assessment of disease activity in rheumatoid arthritis.

C-reactive protein (CRP) levels were measured in 105 patients with rheumatoid arthritis (RA) during treatment with slow-acting anti-rheumatoid drugs D-penicillamine, alclofenac, hydroxychloroquine, gold, sulphasalazine and azathioprine. A control group treated with aspirin alone was also included. Patients were assessed clinically (pain score, articular index and summated change score) and in terms of acute-phase reactants (CRP, haptoglobin, fibrinogen, ESR and plasma viscosity) at eight separate clinic visits during the 6-month treatment period. The estimation of CRP was found to be more useful than haptoglobin, fibrinogen or ESR as an index of disease activity.

Acute-Phase Proteins↗
PubMed1984

A double-blind comparison of tenoxicam (Tilcotil, Mobiflex) at two doses against ibuprofen in rheumatoid arthritis.

Tenoxicam (Tilcotil, Mobiflex), a new non-steroidal anti-inflammatory agent of the oxicam group, has been compared at two dose levels (20 mg/day and 4 mg/day) to ibuprofen 800 mg t.d.s. in a double-blind parallel group study of four weeks duration in rheumatoid arthritis. Efficacy results showed no significant difference between the three treatments at two or four weeks though clinical assessments slightly favoured groups treated with tenoxicam in this 30 patient study. No patients withdrew from tenoxicam because of side-effects and there were no withdrawals because of inefficacy. The higher dose (40 mg) of tenoxicam was as well tolerated as the lower dose (20 mg) though plasma levels of tenoxicam suggested that at the lower dose this drug had barely reached optimum plasma levels in a study of relatively short duration.

Adult↗