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
The aim of this investigation was to formulate,characterize and evaluate etoricoxib(ET)loaded polymeric nanoparticles for topical delivery.For nanoprecipitation method,ethyl cellulose(EC)was used as polymers.All the f...The aim of this investigation was to formulate,characterize and evaluate etoricoxib(ET)loaded polymeric nanoparticles for topical delivery.For nanoprecipitation method,ethyl cellulose(EC)was used as polymers.All the formulations were prepared by varying the drug and polymer concentrations.The obtained nanoparticles were evaluated for yield,drug content,entrapment efficiency,loading capacity and in-vitro drug release.Comparative study was performed among the formulations of ethyl cellulose.For the formulation of the gel,carbopol 934 was used as a gelling base.By comparison,F3 formulation of ethyl cellulose was found to be the best with the highest entrapment efficiency of 79.1%,the smallest mean particle diameter(538 nm),a higher stability(–43.8 mV)and the ability to control the release for 12 h with 87.1% drug release.F3 formulation was incorporated into gel F3G.Based on the results,it could be concluded that F3G formulation of etoricoxib topical gel prepared with ethyl cellulose was found to be more efficient with the highest spreadability of 41.22 g.cm/sec and was able to sustain the drug release for about 12 h with a cumulative release of 79.1%.展开更多
The main objective of this study is to formulate etoricoxib niosomes as vesicular carriers for site specific drug delivery.Niosomes are novel vesicular carriers,in which the drug is incorporated in a vesicle.Niosomal ...The main objective of this study is to formulate etoricoxib niosomes as vesicular carriers for site specific drug delivery.Niosomes are novel vesicular carriers,in which the drug is incorporated in a vesicle.Niosomal vesicles are formed by hydrating mixture of cholesterol and nonionic surfactants.Niosomes can increase the permeability of the skin(stratum corneum and epidermis),by avoiding the first pass metabolism and also reduce the side effects.Etoricoxib is a potent new COX-2 inhibitor used in the treatment of osteoarthritis,rheumatoid arthritis,ankylosing spondylitis,acute gout arthritis etc.Two formulations were prepared by thin film hydration technique using the drug,cholesterol and surfactants Tween 80(F1)and Span 60(F2).Another two formulations were prepared by ether injection method using cholesterol and surfactants Tween 80(F3)and Span 60(F4).Each formulation was evaluated for drug content,entrapment efficiency,mean vesicular diameter,zeta potential and In-vitro drug release studies.Among the four formulations,F2 formulation containing the drug and Span 60 showed maximal drug content of 95.57%,entrapment efficiency of 96.40%,mean vesicular diameter of 463.7 nm,zeta potential of-80.5 mV,in-vitro drug release of 95.14%in 12 h,and the drug release followed the first order with non-fickian diffusion mechanism by thin film hydration technique.Hence,the thin film hydration technique is an optimized technique for the preparation of etoricoxib niosomes.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The aim of this investigation was to formulate,characterize and evaluate etoricoxib(ET)loaded polymeric nanoparticles for topical delivery.For nanoprecipitation method,ethyl cellulose(EC)was used as polymers.All the formulations were prepared by varying the drug and polymer concentrations.The obtained nanoparticles were evaluated for yield,drug content,entrapment efficiency,loading capacity and in-vitro drug release.Comparative study was performed among the formulations of ethyl cellulose.For the formulation of the gel,carbopol 934 was used as a gelling base.By comparison,F3 formulation of ethyl cellulose was found to be the best with the highest entrapment efficiency of 79.1%,the smallest mean particle diameter(538 nm),a higher stability(–43.8 mV)and the ability to control the release for 12 h with 87.1% drug release.F3 formulation was incorporated into gel F3G.Based on the results,it could be concluded that F3G formulation of etoricoxib topical gel prepared with ethyl cellulose was found to be more efficient with the highest spreadability of 41.22 g.cm/sec and was able to sustain the drug release for about 12 h with a cumulative release of 79.1%.
文摘The main objective of this study is to formulate etoricoxib niosomes as vesicular carriers for site specific drug delivery.Niosomes are novel vesicular carriers,in which the drug is incorporated in a vesicle.Niosomal vesicles are formed by hydrating mixture of cholesterol and nonionic surfactants.Niosomes can increase the permeability of the skin(stratum corneum and epidermis),by avoiding the first pass metabolism and also reduce the side effects.Etoricoxib is a potent new COX-2 inhibitor used in the treatment of osteoarthritis,rheumatoid arthritis,ankylosing spondylitis,acute gout arthritis etc.Two formulations were prepared by thin film hydration technique using the drug,cholesterol and surfactants Tween 80(F1)and Span 60(F2).Another two formulations were prepared by ether injection method using cholesterol and surfactants Tween 80(F3)and Span 60(F4).Each formulation was evaluated for drug content,entrapment efficiency,mean vesicular diameter,zeta potential and In-vitro drug release studies.Among the four formulations,F2 formulation containing the drug and Span 60 showed maximal drug content of 95.57%,entrapment efficiency of 96.40%,mean vesicular diameter of 463.7 nm,zeta potential of-80.5 mV,in-vitro drug release of 95.14%in 12 h,and the drug release followed the first order with non-fickian diffusion mechanism by thin film hydration technique.Hence,the thin film hydration technique is an optimized technique for the preparation of etoricoxib niosomes.
