Dexketoprofen: therapeutic potential in neurology

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Abstract

At present non-steroid anti-inflammatory drugs (NSAID) remain the basis for acute pain syndrome of any intensity treatment. In clinical neurologysts' practice NSAID are mostly used in musculoskeletal system disorders treatment and for headaches abortion. The concern is to choose a right medication for the patient considering all indications and contraindications, to determine an adequate dosage or a combination of several analgetic drugs. In the meantime it is recommended to use medications with maximal rate of analgesic effect development and minimal risk of adverse effects in gastrointestinal tract development without loss of effectiveness. Dexketoprofen trometamol, a dextrarotatory isomer of ketoprophen, is one of these medications from NSAID group. The drug is highly purified from R(-)-ketoprophen (99.9%), and has improved physico-chemical properties. The article describes its mechanisms of action, and presents clinical studies results that demonstrate dexketoprofen trometamol (Dexalgin®) analgetic effectiveness and tolerance with the primary indication for use in neurology in musculoskeletal pain and migrainous headaches treatment.

About the authors

A. A Pilipovich

I.M.Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation

Email: aapilipovich@mail.ru
канд. мед. наук, доц. каф. нервных болезней ИПО 119991, Russian Federation, Moscow, ul. Trubetskaia, d. 8, str. 2

References

  1. Алексеев В.В., Баринов А.Н., Кукушкин М.Л. и др. Боль. Руководство для врачей и студентов. Под ред. Н.Н.Яхно. М.: Медпресс-информ, 2009.
  2. Рябоконь И.В. Современный взгляд на лечение боли в спине. Справочник поликлинического врача. 2009; 3: 78-81.
  3. Mauleon D, Artigas R, Garcнa M.L, Carganico G. Preclinical and clinical development of dexketoprofen. Drugs 1996; 52 (Suppl. 5): 24-45.
  4. Barbanoj M.J, Gich I, Artigas R et al. Pharmacokinetics of dexketoprofen trometamol in healthy volunteers after single and repeated oral doses. Drugs 1998; 52 (Suppl. 5): 24-45.
  5. McEwen J, De Luca M, Casini A et al. The effect of food and an antacid on the bioavailability of dexketoprofen trometamol. J Clin Pharmacol 1998; 38 (Suppl. 12): 33S-40S.
  6. Карнеев А.Н. Практика лечения боли в спине. Consilium Medicum. 2017; 19 (2.2. Неврология и Ревматология): 32-6.
  7. Moore R.A, Barden J. Systematic review of dexketoprofen in acute and chronic pain. BMC Clin Pharmacol 2008; 8: 11.
  8. Zippel H, Wagenitz A. Comparison of the efficacy and safety of intravenously administered dexketoprofen trometamol and ketoprofen in the management of pain after orthopaedic surgery: A multicentre, double-blind, randomised, parallelgroup clinical trial. Clin Drug Investig 2006; 26: 517-28.
  9. Zapata A, Cegarra F, Artigas R, Keller F. Dexketoprofen vs tramadol: randomised double-blind trial in patients with postoperative pain. British J Clin Pharmacol 2000; 223: abs 870.
  10. Hanna M.H, Elliott K.M, Stuart-Taylor M.E et al. Comparative study of analgesic efficacy and morphine-sparing effect of intramuscular dexketoprofen trometamol with ketoprofen or placebo after major orthopaedic surgery. Br J Clin Pharmacol 2003; 55: 126-133.
  11. Jackson I.D, Heidemann B.H, Wilson J et al. Doubleblind, randomized, placebo-controlled trial comparing rofecoxib with dexketoprofen trometamol in surgical dentistry. Br J Anaesth 2004; 92: 675-80.
  12. McGurk M, Robinson P, Rajayogeswaran V et al. Clinical comparison of dexketoprofen trometamol, ketoprofen, and placebo in postoperative dental pain. J Clin Pharmacol 1998; 38 (Suppl. 12): 46S-54S.
  13. Munoz G, Berini L, Sanchez S et al. Preoperative dexketoprofen trometamol for the prevention of postoperative dental pain: a randomised double-blind clinical trial. Method Find Exp Clin Pharmacol 1998; 20 (Suppl A): 69.
  14. Sanchez-Carpena J, Dominguez-Hervella F, Garcia I et al; Dexketoprofen Renal Colic Study Group. Comparison of intravenous dexketoprofen and dipyrone in acute renal colic. Eur J Clin Pharmacol 2007; 63 (8): 751-60.
  15. Zippel H, Wagenitz A. A multicentre, randomised, double-blind study comparing the efficacy and tolerability of intramuscular dexketoprofen versus diclofenac in the symptomatic treatment of acute low back pain. Clin Drug Investig 2007; 27: 533-43.
  16. Metscher B, Kubler U, Jahnel-Kracht H. Dexketoprofen-trometamol and tramadol in acute lumbago. Fortschr Med Orig 2001; 118: 147-51.
  17. Marenco J.L, Pérez M, Navarro F.J et al. A multicentre, randomised, double-blind study to compare the efficacy and tolerability of dexketoprofen trometamol versus diclofenac in the symptomatic treatment of knee osteoarthritis. Clin Drug Invest 2000; 19: 247-56.
  18. Ezcurdia M, Cortejoso F.J, Lanzon R et al. Comparison of the efficacy and tolerability of dexketoprofen and ketoprofen in the treatment of primary dysmenorrhea. J Clin Pharmacol 1998; 38 (Suppl. 12): 65S-73S.
  19. Rodriguez M.J, Contreras D, Galvez R et al. Double-blind evaluation of short-term analgesic efficacy of orally administered dexketoprofen trometamol and ketorolac in bone cancer pain. Pain 2003; 104: 103-10.
  20. Leman P, Kapadia Y, Herington J. Randomised controlled trial of the onset of analgesic efficacy of dexketoprofen and diclofenac in lower limb injury. Emerg Med J 2003; 20: 511-3.
  21. Beltra’n J et al. Comparison of Dexketoprofen trometamol and ketoprofen in the treatment of osteoartritis of the knee. J Clin Pharmacol 1998; 38: 74S-80S.
  22. Capriai A, Mas M, Bertoloti M et al. Intramuscular dexketoprofen trometamol in acute lower back pain. 10th World Congress on Pain, IASP, California, 2002; p. 108-12.
  23. Metscher B, Kubler U et al. Dexketoprofen-trometamol and tramadol in acute lumbago. Fortschr Med Orig 2001; 118 (4): 147-51.
  24. Подчуфарова Е.В. Опыт применения препарата Дексалгин® при лечении острых скелетно-мышечных болевых синдромов. Эффективная фармакотерапия. Неврология и Психиатрия. 2012; 2: 34-9.
  25. Меркулов Ю.А., Меркулова Д.М., Крыжановский Г.Н. Эффективность дексалгина на вертеброгенные и невертеброгенные механизмы дизрегуляции при болях в спине. Журн. неврологии и психиатрии им. С.С.Корсакова. 2006; 106 (5): 20-4.
  26. Соловьева Э.Ю., Карнеев А.Н., Федин А.И. Сочетанное применение дексалгина и нимесила в стадии обострения дорсопатии. Врач. 2007; 3: 67-71.
  27. Подчуфарова Е.В., Яхно Н.Н. Боли в спине и конечностях. В кн.: Болезни нервной системы. Руководство для врачей. Под ред. Н.Н.Яхно. Т. 2. М., 2005; с. 306-31
  28. Krymchantowski A.V, Jevoux C.C. The experience of combining agents, specially triptans and non steroidal anti-inflammatory drugs, for the acute treatment of migraine - a review. Recent Pat CNS Drug Discov 2007; 2: 141-4.
  29. Tullo V, Valguarnera F, Barbanti P et al. Comparison of frovatriptan plus dexketoprofen (25 mg or 37.5 mg) with frovatriptan alone in the treatment of migraine attacks with or without aura: A randomized study. Cephalalgia 2014; 34: 434-45.
  30. Allais G, Rolando S, Schiapparelli P et al. Frovatriptan plus dexketoprofen in the treatment of menstrually related migraine. An open study. Neurol Sci 2013; 34 (Suppl. 1): S179-S181.
  31. Elkind A.H and MacGregor E.A. Frovatriptan for the acute treatment of migraine and prevention of predictable menstrual migraine. Expert Rev Neurother 2008; 8: 723-36.
  32. Allais G, Bussone G, Tullo V et al. Frovatriptan 2.5 mg plus dexketoprofen (25 mg or 37.5 mg) in menstrually related migraine. Subanalysis from a double-blind, randomized trial. Cephalalgia 2015; 35 (1): 45-50.

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