Aceclofenac: a reappraisal of its use in the management of pain and rheumatic disease
- PMID: 11511027
- DOI: 10.2165/00003495-200161090-00012
Aceclofenac: a reappraisal of its use in the management of pain and rheumatic disease
Abstract
Aceclofenac is an orally administered phenylacetic acid derivative with effects on a variety of inflammatory mediators. Through its analgesic and anti-inflammatory properties, aceclofenac provides symptomatic relief in a variety of painful conditions. In patients with osteoarthritis of the knee, the drug decreases pain, reduces disease severity and improves the functional capacity of the knee to a similar extent to diclofenac, piroxicam and naproxen. Aceclofenac reduces joint inflammation, pain intensity and the duration of morning stiffness in patients with rheumatoid arthritis, and is similar in efficacy to ketoprofen, diclofenac, indomethacin and tenoxicam in these patients. The duration of morning stiffness and pain intensity are reduced, and spinal mobility improved, by aceclofenac in patients with ankylosing spondylitis, with improvements being similar to those observed with indomethacin, naproxen or tenoxicam. Aceclofenac is also effective in other painful conditions (e.g. dental and gynaecological). In contrast to some other NSAIDs, aceclofenac has shown stimulatory effects on cartilage matrix synthesis. Aceclofenac is well tolerated, with most adverse events being minor and reversible, and affecting mainly the GI system. Although the incidence of GI adverse events with aceclofenac was similar to those of comparator NSAIDs in individual clinical trials, withdrawal rates due to these events were significantly lower with aceclofenac than with ketoprofen and tenoxicam. Superior overall and/or GI tolerability of the drug relative to other NSAIDs has been indicated by a nonrandomised comparison with sustained release diclofenac in 10,142 patients, a meta-analysis of 13 comparisons with diclofenac, naproxen, piroxicam, indomethacin, tenoxicam or ketoprofen in 3574 patients, and preliminary details of a comparison with 10 other NSAIDs in 142,776 patients. Further analysis of the above meta-analytical data has indicated that costs incurred as a result of adverse event management are lower with aceclofenac than with a range of comparator NSAIDs.
Conclusions: Trials of 2 to 6 months' duration have shown aceclofenac to be an effective agent in the management of pain and rheumatic disease. Data from in vitro studies indicate properties of particular interest with respect to cartilage matrix effects and selectivity for cyclo-oxygenase-2. Aceclofenac is well tolerated, with encouraging reports of improved general and GI tolerability relative to other NSAIDs from a meta-analysis of double-blind trials and from large nonblind studies.
Similar articles
-
Aceclofenac. A review of its pharmacodynamic properties and therapeutic potential in the treatment of rheumatic disorders and in pain management.Drugs. 1996 Jul;52(1):113-24. doi: 10.2165/00003495-199652010-00008. Drugs. 1996. PMID: 8799688 Review.
-
Aceclofenac in the management of inflammatory pain.Expert Opin Pharmacother. 2004 Jun;5(6):1347-57. doi: 10.1517/14656566.5.6.1347. Expert Opin Pharmacother. 2004. PMID: 15163279 Review.
-
[Pharma-clinics. The drug of the month. Aceclofenac (Biofenac)].Rev Med Liege. 1999 Jan;54(1):62-4. Rev Med Liege. 1999. PMID: 10081315 Review. French.
-
Comparison of gastrointestinal safety and tolerability of aceclofenac with diclofenac: a multicenter, randomized, double-blind study in patients with knee osteoarthritis.Curr Med Res Opin. 2013 Jul;29(7):849-59. doi: 10.1185/03007995.2013.795139. Epub 2013 Apr 30. Curr Med Res Opin. 2013. PMID: 23581533 Clinical Trial.
-
[What is the role of aceclofenac in the therapeutic arsenal against chronic osteoarthritis pathologies?].Rev Med Liege. 2001 Jul;56(7):484-8. Rev Med Liege. 2001. PMID: 11523298 Review. French.
Cited by
-
Application of HPLC for the simultaneous determination of aceclofenac, paracetamol and tramadol hydrochloride in pharmaceutical dosage form.Sci Pharm. 2012 Apr-Jun;80(2):337-51. doi: 10.3797/scipharm.1108-04. Epub 2012 Jan 31. Sci Pharm. 2012. PMID: 22896821 Free PMC article.
-
A Review of Aceclofenac: Analgesic and Anti-Inflammatory Effects on Musculoskeletal Disorders.J Pain Res. 2021 Nov 30;14:3651-3663. doi: 10.2147/JPR.S326101. eCollection 2021. J Pain Res. 2021. PMID: 34876850 Free PMC article. Review.
-
Upregulated lncRNA-NEF predicts recurrence and poor treatment outcomes of ankylosing spondylitis.Immun Inflamm Dis. 2022 Aug;10(8):e627. doi: 10.1002/iid3.627. Immun Inflamm Dis. 2022. PMID: 35894706 Free PMC article.
-
Effects of ibuprofen on molecular markers of cartilage and synovium turnover in patients with knee osteoarthritis.Ann Rheum Dis. 2004 Jul;63(7):857-61. doi: 10.1136/ard.2003.007302. Ann Rheum Dis. 2004. PMID: 15194584 Free PMC article. Clinical Trial.
-
Efficacy and Safety of Aceclofenac Controlled Release in Patients with Knee Osteoarthritis: A 4-week, Multicenter, Randomized, Comparative Clinical Study.Knee Surg Relat Res. 2014 Mar;26(1):33-42. doi: 10.5792/ksrr.2014.26.1.33. Epub 2014 Feb 27. Knee Surg Relat Res. 2014. PMID: 24639945 Free PMC article.
References
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Medical
Research Materials