Anti-prostaglandin and anti-inflammatory short-term efficacy of piroxicam in rheumatoid arthritis.

Abstract

The efficacy of anti-inflammatory agents is related to their concentration in the peripheral compartments. In rheumatoid arthritis a drug's affinity for synovial tissue and synovial fluid is a decisive factor in treatment. The short-term efficacy of piroxicam was studied, relating the synovial concentration of prostaglandins and acid phosphatase and LDH to piroxicam synovial and plasma levels. After withdrawal of synovial fluid for pre-treatment measurements, 10 patients received 20 to 30 mg of piroxicam/day for eight days. The drug reached an average level of 3.56 +/- 0.9 micrograms/ml in synovial fluid, and 7.73 +/- 1.6 micrograms/ml in plasma. The acid phosphatase decreased from an initial average level of 29 mu/ml to a final average level of 15.999 mu/ml. The LDH showed an initial average level of 725.3 mu/ml and a final average of 471.2 mu/ml (p less than 0.01). The prostaglandin levels were quantified by two methods: indirectly, by measuring the malonilaldehyde concentration in nMol/ml, which showed an average level decrease of 48.75% in 100% of the cases; and directly, by means of thin layer chromatography and biological assay on rats' gastric fundus, against controls. The disappearance of PGE1 and a significant decrease in PGF2 alpha (100%) were observed. We conclude that piroxicam is an effective drug for the short-term treatment of rheumatoid arthritis. It penetrates rheumatoid synovial fluid, reaching 50% plasma concentrations. It has an anti-prostaglandin action, and could stabilize lysosomal membrane.

• Authors: A Strusberg, H Montrull, C I Meirovich
• Journal: European journal of rheumatology and inflammation (Eur J Rheumatol Inflamm) Vol. 6 Issue 1 Pg. 41-5 ( 1983) ISSN: 0140-1610 [Print] England
• PMID: 6574910 (Publication Type: Journal Article)

Chemical References

• Anti-Inflammatory Agents
• Prostaglandin Antagonists
• Prostaglandins E
• Prostaglandins F
• Thiazines
• Piroxicam
• Dinoprost
• L-Lactate Dehydrogenase
• Acid Phosphatase
• Alprostadil

Topics

• Acid Phosphatase (metabolism)
• Adult
• Alprostadil
• Anti-Inflammatory Agents (therapeutic use)
• Arthritis, Rheumatoid (drug therapy)
• Dinoprost
• Humans
• L-Lactate Dehydrogenase (metabolism)
• Middle Aged
• Piroxicam
• Prostaglandin Antagonists (therapeutic use)
• Prostaglandins E (metabolism)
• Prostaglandins F (metabolism)
• Synovial Fluid (cytology, metabolism)
• Thiazines (blood, therapeutic use)