Side effects of anti-inflammatory drugs IV : the proceedings of the IVth International Meeting on Side Effects of Anti-inflammatory Drugs, held in Sheffield, UK, 7-9, August 1995

Recent concern about the adverse effects and relative risks of anti- inflammatory therapies has been such that another meeting was organized in the highly successful series of meetings on this topic. Adverse effects of anti-rheumatic and anti-inflammatory drugs are of major concern to all involved in the prescription, care and management of rheumatic and other patients receiving these important drugs. The IVth International Meeting on Side-Effects of Anti-Inflammatory Drugs, held in Sheffield, UK, 7-9 August 1995, afforded a unique opportunity to hear the latest information and views on issues concerning the development of adverse effects from these drugs, the management of these effects, and the development of safer therapies. In addition to discussions on the safety relative to efficacy of established non-steroidal and steroidal anti-inflammatory drugs and disease-modifying agents, there was detailed consideration of the novel cyclo-oxygenase-2 selective NSAIDs which have recently been developed and introduced to the clinic. Also, the side effects from therapy with biologics, notably monoclonal antibodies and oral tolerance therapies, were considered. Among the other highlights in the programme were: * Clinico-epidemiological studies on the adverse effects relative to use/efficacy of established and new anti-rheumatic drugs. * Procedures for reducing the gastrointestinal adverse effects. * Mechanisms and clinical significance of adverse effects in the gastrointestinal tract, liver, kidney, articular joints, skin and other organs from NSAIDs. * Clinical status and mechanisms of action of the newer (third generation) of NSAIDs (e.g. etodolac, nabumetone, meloxicam). * Medico-legal aspects of adverse effects from anti-rheumatic drugs. * The concept of `conditional pharmacology' or the disease-dependence of the toxicological and pharmacological activity of the anti-inflammatory drugs. The papers in this book were selected from those presented at the meeting. Front Matter....Pages i-xii Front Matter....Pages 1-1 Current Status of Side-Effects from Anti-Inflammatory Drugs....Pages 3-7 Front Matter....Pages 9-9 The Placebo Response: Clinical Efficacy and Toxicity....Pages 11-23 Side-Effects of Non-Steroidal Anti-Inflammatory Drugs: Studies from the Tayside Medicines Monitoring Unit....Pages 25-30 Treatment Decisions, Side-Effect Liability and Cost-Effectiveness in Osteoarthritis....Pages 31-34 Measuring Beneficial and Adverse Events in Osteoarthritis Clinical Trials....Pages 35-42 Do NSAIDs Adversely Affect Joint Pathology in Osteoarthritis?....Pages 43-53 Safety of Non-Steroidal Anti-Inflammatory Drugs during Pregnancy and Lactation....Pages 55-65 Side-Effects from Biologics in the Therapy of Rheumatic Diseases....Pages 67-76 Oral Tolerance from a General Perspective, and the Possible Role of Side-Effects in the Gut....Pages 77-80 Summary of Debate....Pages 81-84 Front Matter....Pages 85-85 The Concept of Conditional Pharmacology and Toxicology....Pages 87-95 Inflammation, Stress and Environmental Factors as Determinants of Nsaid Efficacy and Toxicity....Pages 97-101 Do You Really Know What Your Drug Looks Like or How it Reacts?....Pages 103-118 Front Matter....Pages 119-119 Intestinal Pathology from NSAIDs....Pages 121-138 A Clinician’s View of Strategies for Preventing Nsaid-Induced Gastrointestinal Ulcers....Pages 139-152 Protection from Nsaid-Induced Gastrointestinal Damage....Pages 153-159 An Overview of the Key Role of Misoprostol in the Prophylaxis of Nsaid-Associated Ulcers and Their Complications....Pages 161-170 Clinical Update of the Relative Safety of Nabumetone in Long-Term Clinical Trials....Pages 171-181 Global Analysis of Gastrointestinal Safety of a New Nsaid, Meloxicam....Pages 183-193 Front Matter....Pages 195-195 Gastrointestinal Adaptation, Regulation of Eicosanoids, and Mucosal Protection from NSAIDs....Pages 197-205 Front Matter....Pages 195-195 New Insight into Nsaid-Induced Gastropathy....Pages 207-210 Cyclooxygenase Selectivity and NSAIDs: Cyclooxygenase-2 Selectivity of Etodolac (Lodine)....Pages 211-221 Differential Inhibition of Cyclooxygenase-1 (COX-1) and -2 (COX-2) by NSAIDs: Consequences on Anti-Inflammatory Activity Versus Gastric and Renal Safety....Pages 223-232 Polymer Delivery of the Mucosal Protective Prostaglandin Misoprostol....Pages 233-234 Nitric Oxide-Releasing NSAIDs, a Novel Class of Safe and Effective Anti-Inflammatory Agents....Pages 235-242 Mitochondrial Function and Modification of Nsaid Carboxyl Moiety....Pages 243-248 Effects of a New Class of No-Releasing NSAIDs on Platelets and Isolated Arteries....Pages 249-256 A 1 and A 2 Adenosine Receptors Mediate Opposite Effects on Nsaid-Induced Gastric Ulcers in the Rat....Pages 257-263 Role of Vagal Nerve in Defence Mechanisms against NSAID-Induced Gastrointestinal Mucosal Damage....Pages 265-286 Analysis of the Inhibiting Activity of Presynaptic α 2 -Adrenoceptors against NSAID-induced Gastric Mucosal Lesions in the Rat....Pages 287-294 Front Matter....Pages 295-295 Mechanisms of Adverse Reactions in the Skin from Anti-Rheumatic Drugs....Pages 297-303 Can In-Vitro Assays Predict Chemically-Induced Skin Damage?....Pages 305-314 Front Matter....Pages 315-315 The Use of Ketorolac Tromethamine Oral Rinse for the Treatment of Periodontitis in Adults....Pages 317-324 Front Matter....Pages 325-325 Variability in Risk of Major Upper Gastro-Intestinal Complications with Individual NSAIDs. Importance of Drug Dose and Half-Life; Results of Meta Analysis....Pages 327-327 Non-Steroidal Associated Ulcer Bleeding — Defining the Risk Factors....Pages 328-328 Variability in Exposure to NSAIDs in Relation to Safety....Pages 328-329 Non-Steroidal Anti-Inflammatory Drugs and Infertility....Pages 329-330 Perioperative Use of NSAID and Postoperative Infectious Complications....Pages 330-330 Medico-Legal Issues of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)....Pages 330-332 The Use of DMARDs and Combination Therapies....Pages 333-333 Front Matter....Pages 325-325 Non-Steroidal Anti-Inflammatory Drugs and Acute Appendicitis: A Case-Control Study....Pages 333-334 Non-Steroidal Anti-Inflammatory Drugs and Colitis: A Record-Linkage Case-Control Study....Pages 334-334 New Exposure to NSAIDs and Hospitalisation for Upper Gastrointestinal Events....Pages 335-335 Topical NSAIDs and Upper Gastrointestinal Bleeding and Perforation....Pages 335-336 Non-Steroidal Anti-Inflammatory Drugs, Aspirin and Colo-Rectal Cancer....Pages 336-337 The Pattern of Prescribing of Community Dispensed Ulcer-Healing Drugs in Tayside....Pages 337-338 Clinical Trials of the Relative Safety of Nabumetone in Long-Term Clinical Trials: Proposed Rationale for Safety Profile....Pages 338-339 Cyclooxygenase-2: A Novel Target for Safer Anti-Inflammatory Drugs....Pages 339-340 Inhiibitory Action of Hydrophilic Polymers on Gastric Lesions Induced by Indomethacin in Rats....Pages 340-341 Copper-Derivatives and Gastroprotection....Pages 341-342 The β 3 -Adrenoceptor Agonist CL316243 Prevents Indomethacin-Induced Jejunal Ulceration in the Rat....Pages 343-344 Front Matter....Pages 345-345 The Dilemma of Modern Medicine....Pages 347-350 Back Matter....Pages 351-356