ESTUDIO EPIDEMIOLÓGICO PARA VALORAR LA ADHESIÓN DE LOS CIRUJANOS VASCULARES ESPAÑOLES AL DOCUMENTO DE CONSENSO TASC II PARA EL TRATAMIENTO DE LA ENFERMEDAD ARTERIAL PERIFÉRICA Resumen. Introducción. ...La enfermedad arterial periférica (EAP) se considera la arteriopatía no cardíaca de mayor prevalencia. En la guía médica TASC II, publicada en 2007, se describen los procedimientos para el diagnóstico y tratamiento de esta enfermedad. Objetivo. Evaluar la adhesión a la guía TASC II por parte de los médicos de los servicios de cirugía vascular en los hospitales españoles. Pacientes y métodos. A partir de la historia clínica de pacientes dados de alta en los servicios de cirugía vascular diagnosticados de EAP, se recogieron datos sobre las características del paciente, diagnóstico, seguimiento y tratamiento de la EAP. Estos datos se compararon con las recomendaciones de la guía TASCII. Resultados. Se incluyeron 1.456pacientes tratados en 63 hospitales. Se observó un cumplimiento global con la guía TASC II del 62,43%, mientras que la adhesión a la guía en función de sus diferentes bloques varió, y los procesos de revascularización junto con el tratamiento de los factores de riesgo fueron los bloques con una adhesión superior (el 82,4 y el 84,96%, respectivamente). El bloque de recomendaciones con el que menos se cumplió correspondió al tratamiento de la claudicación intermitente (24,8%). Por último, respecto a los bloques relacionados con el tratamiento de la isquemia crítica y la isquemia aguda de la extremidad se obtuvieron adhesiones del 78,46y del 60,1%, respectivamente. Conclusiones. En este estudio se ha obtenido información valiosa sobre la práctica habitual médico-quirúrgica en el tratamiento de los pacientes diagnosticados de EAP en España, y se ha observado un mayor cumplimiento con la guía TASC II en los bloques de revascularización y de control de los factores de riesgo. ANGIOLOGÍA 2009; 61: 1–11
The efficacy and safety of aceclofenac (100 mg bid), a new nonsteroidal anti-inflammatory/anti-rheumatic agent, were compared with those of naproxen (500 mg bid) in a multi-centre, twelve-week, ...randomized, double-blind, parallel-group clinical trial in outpatients with active osteoarthritis of the knee. 190 patients received aceclofenac, 184 naproxen. The two treatments were compared on the basis of several characteristic clinical features of osteoarthritis of the knee, including various pain measurements. In both groups, the treatment resulted in a significant reduction of the pain at rest, pain on movement and the pain from pressure on the joint, 76-86% of aceclofenac patients reporting reduction in pain after 12 weeks. Three-quarters of the aceclofenac-treated patients had an accompanying reduction in joint swelling and 81.4% in knee function capacity, up to complete freedom of movement. Joint stiffness, which at baseline lasted 20 minutes, was reduced in the aceclofenac group to 10 minutes. A statistically significant difference in the efficacy of the two drugs was not found. The 34 adverse drug effects documented in 24 (12.6%) of the aceclofenac patients were fewer than the 43 events in 30 patients (16.3%) reported for naproxen. The trend towards better tolerability of aceclofenac manifested itself above all in a lower total incidence of gastrointestinal side-effects. Aceclofenac is as effective as naproxen in the symptomatic treatment of osteoarthritis of the knee and is well tolerated in general.
The efficacy and safety of aceclofenac 1.5% cream and piroxicam 1% cream in 220 patients with soft-tissue injuries were evaluated in a double-blind, randomized, multicenter, comparative, ...parallel-group trial. Patients were randomly assigned to each treatment group to receive therapy three times a day for 7 days. The primary outcome measure of pain was evaluated using a visual analog scale (VAS) at baseline, day 4, and day 7 of the study. Safety was assessed by recording any adverse events that occurred and by monitoring any hemato-biochemical alterations during the study. After days 4 and 7 of treatment, a significant improvement (
P < 0.05) was observed for both groups with respect to baseline conditions for all efficacy variables evaluated. The statistical analysis showed no significant differences between treatments for all parameters except for subjective pain, which favored the piroxicam group (
P < 0.05). Both topical formulations were well tolerated: Only local adverse events of mild intensity were reported by three patients treated with aceclofenac. The overall assessment of tolerability was reported by physicians and patients as being either good or very good in both groups. The results of this study confirm that aceclofenac cream is effective in relieving pain, improving functional capacity, and reducing swelling related to acute injuries of soft tissues.
To compare in a 3 month, multicenter, double blind, parallel study the efficacy and safety of a nonsteroidal antiinflammatory drug, aceclofenac, 100 mg bid orally, with that of tenoxicam, 20 mg ...orally at bedtime, in the treatment of adult patients with active ankylosing spondylitis (AS).
A total of 273 patients (135 in the aceclofenac group and 138 in the tenoxicam group) entered the study. Eight efficacy variables were assessed: morning stiffness, visual analog pain scale, control of additional paracetamol, modified Schöber's test, C7 line-iliac crest distance, lateral flexion of the spine, thoracic expansion, and occiput-wall distance.
Seven of the 8 variables improved significantly in both groups, with no differences between the 2 groups in any variable at the end of the study. Six percent of patients taking aceclofenac and 5% of patients taking tenoxicam withdrew because of unsatisfactory therapeutic action. Forty-two adverse events possibly or probably related to treatment were observed in the aceclofenac group and 37 in the tenoxicam group. However, only 2.2% of patients in the aceclofenac group and 1.4% in the tenoxicam group withdrew for this reason.
Aceclofenac and tenoxicam are similar in terms of safety and effectiveness; and aceclofenac, 100 mg orally twice daily, is a safe, effective, and convenient treatment for active AS.
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