- Email: [email protected]
A parallel-group comparison study of celecoxib with loxoprofen sodium in wisdom tooth extraction patients
Poster Session References: 1. Phychiatric diagnosis in patients with burning mouth syndrome and atypical odontalgia referred from psychiatric to dental facilities. Takenoshita M, Sato T, Kato Y, Katagiri A, Yoshikawa T, Sato Y, Matsushima E, Sasaki Y, Toyofuku A. Neuropsychiatr Dis Treat. 2010 Oct 13;6:699-705. 2. Effectiveness of duloxetine for the treatment of chronic nonorganic orofacial pain. Nagashima W, Kimura H, Ito M, Tokura T, Arao M, Aleksic B, Yoshida K, Kurita K, Ozaki N. Clin Neuropharmacol. 2012 Nov-Dec;35(6):273-7.
POSTER 115 A parallel-group comparison study of celecoxib with loxoprofen sodium in wisdom tooth extraction patients Y. Yamashita: Saga University, Faculty of Medicine, N. Sano, R. Aijima, D. Shimohira, A. Danjo, M. Goto Celecoxib, a selective COX-2 inhibitor, is used to treat chronic pain from rheumatoid arthritis or osteoarthritis, and there are hopes that it may be also be useful for acute pain following surgery, trauma, or tooth extraction. Wisdom tooth extraction is the most common oral surgical procedure. A number of different NSAIDs are currently used for post-extraction analgesia, but since most of these are non-selective COX inhibitors, they entail the risk of gastrointestinal damage, including gastrointestinal ulcers, perforation, obstruction, and hemorrhage. In this study, patients who had undergone wisdom tooth extraction were given either loxoprofen sodium, the NSAID most frequently used in Japan for this purpose, or the selective COX-2 inhibitor celecoxib, and their efficacy and safety were compared. This was a parallel-group comparison study, in which 107 patients who had undergone wisdom tooth extraction were given celecoxib, and 102 were given loxoprofen. The level of pain on a visual analogue scale (VAS) 15 min and 30 min after taking the experimental drug decreased with the passage of time, with no significant difference between the two groups. The percentage of patients taking a second dose was 64.5% for celecoxib and 80.4% for loxoprofen. The time to second dose was significantly longer for celecoxib (533.5 min) than for loxoprofen (387.4 min). There was no significant difference in efficacy between the two groups in terms of patient’s impression of efficacy, at 77.4% for loxoprofen and 74.5% for celecoxib. These results demonstrated that celecoxib is not inferior to loxoprofen for pain after wisdom tooth extraction, and that its effect is actually more persistent. e-118
POSTER 116 A case of Diffuse Sclerotic Osteomyelitis of the mandible in SAPHO syndrome successfully treated with an oral Bisphosphonate administration A. Ikeda: Okayama University, E. Yamachika, T. Matsumura, M. Mizutani, A. Maeda, N. Kishimoto, Y. Arimura, Y. Yamamoto, S. Tamura, A. Uemura, S. Iida Introduction: SAPHO syndrome, which was proposed in 1987 by Chamot et al1, is an acronym describing a heterogeneous symptom complex of synovitis, acne, pustulosis, hyperostosis, and osteitis(sterile osteomyelitis). We report the case of Diffuse Sclerotic Osteomyelitis of the mandible (DSOM) in SAPHO syndrome that was successfully treated with an oral bisphosphonate. Case report: The patient was 78-year old woman who had a chief complaint of pain in the left mandible area. The patient underwent a Computed Tomography (CT). CT showed osteosclerosis lesions in the left mandible and sternocostal area. And an ununiform bone marrow was detected in the left mandible. Technetium-99m bone scan(99mTc) showed increased uptake in the mandible, the sternum and the costa. A bone biopsy specimen showed little infiltration of inflammatory cells and no evidence of malignancy. Bacterial cultures remained negative. In addition, because the patient had scale in the soles of feet for palmoplantar pustulosis, the patient was diagnosed as SAPHO syndrome. The treatment with non-steroidal anti-inflammatory drugs (NSAIDs) was started but failed to control symptoms, then therapy with an oral administration of bisphosphonate (Alendoronate: 35mg/week) was started. Symptoms disappeared after eight months of oral administration and administration of oral bisphosphonate was finished at that time. In addition, 99m Tc showed a decreased uptake in the left part of the mandible. The patient has been obtained good progress without a recurrence at the present and passed for 65 months on complete remission. Recenly treatment with bisphosphonate of SAPHO patients who is refractory to NSAIDs has been reported2. This report showed that administration of oral bisphosphonate had a dramatic and longstanding effect for a patient of DSOM associated with SAPHO syndrome. Further trials of oral bisphosphonate in patients with DSOM and even in patients with SAPHO syndrome are needed to assess its effectiveness. References: 1. Chamot AM, Benhamou CL, Kahn MF, et al: [Acne-pustulosishyperotosis-osteitis syndrome. Results of a national survey. 85 Cases]. Rev Rhum Mal Osteoartic 54: 187, 1987 2. Hayem G, Bouchaud-Chabot A, Benal K, et al: SAPHO syndrome: A long-term follow-up study of 120 cases. Semin Arthritis Rheum 29:159, 1999
AAOMS 2014
POSTER 115 A parallel-group comparison study of celecoxib with loxoprofen sodium in wisdom tooth extraction patients Y. Yamashita: Saga University, Faculty of Medicine, N. Sano, R. Aijima, D. Shimohira, A. Danjo, M. Goto Celecoxib, a selective COX-2 inhibitor, is used to treat chronic pain from rheumatoid arthritis or osteoarthritis, and there are hopes that it may be also be useful for acute pain following surgery, trauma, or tooth extraction. Wisdom tooth extraction is the most common oral surgical procedure. A number of different NSAIDs are currently used for post-extraction analgesia, but since most of these are non-selective COX inhibitors, they entail the risk of gastrointestinal damage, including gastrointestinal ulcers, perforation, obstruction, and hemorrhage. In this study, patients who had undergone wisdom tooth extraction were given either loxoprofen sodium, the NSAID most frequently used in Japan for this purpose, or the selective COX-2 inhibitor celecoxib, and their efficacy and safety were compared. This was a parallel-group comparison study, in which 107 patients who had undergone wisdom tooth extraction were given celecoxib, and 102 were given loxoprofen. The level of pain on a visual analogue scale (VAS) 15 min and 30 min after taking the experimental drug decreased with the passage of time, with no significant difference between the two groups. The percentage of patients taking a second dose was 64.5% for celecoxib and 80.4% for loxoprofen. The time to second dose was significantly longer for celecoxib (533.5 min) than for loxoprofen (387.4 min). There was no significant difference in efficacy between the two groups in terms of patient’s impression of efficacy, at 77.4% for loxoprofen and 74.5% for celecoxib. These results demonstrated that celecoxib is not inferior to loxoprofen for pain after wisdom tooth extraction, and that its effect is actually more persistent. e-118
POSTER 116 A case of Diffuse Sclerotic Osteomyelitis of the mandible in SAPHO syndrome successfully treated with an oral Bisphosphonate administration A. Ikeda: Okayama University, E. Yamachika, T. Matsumura, M. Mizutani, A. Maeda, N. Kishimoto, Y. Arimura, Y. Yamamoto, S. Tamura, A. Uemura, S. Iida Introduction: SAPHO syndrome, which was proposed in 1987 by Chamot et al1, is an acronym describing a heterogeneous symptom complex of synovitis, acne, pustulosis, hyperostosis, and osteitis(sterile osteomyelitis). We report the case of Diffuse Sclerotic Osteomyelitis of the mandible (DSOM) in SAPHO syndrome that was successfully treated with an oral bisphosphonate. Case report: The patient was 78-year old woman who had a chief complaint of pain in the left mandible area. The patient underwent a Computed Tomography (CT). CT showed osteosclerosis lesions in the left mandible and sternocostal area. And an ununiform bone marrow was detected in the left mandible. Technetium-99m bone scan(99mTc) showed increased uptake in the mandible, the sternum and the costa. A bone biopsy specimen showed little infiltration of inflammatory cells and no evidence of malignancy. Bacterial cultures remained negative. In addition, because the patient had scale in the soles of feet for palmoplantar pustulosis, the patient was diagnosed as SAPHO syndrome. The treatment with non-steroidal anti-inflammatory drugs (NSAIDs) was started but failed to control symptoms, then therapy with an oral administration of bisphosphonate (Alendoronate: 35mg/week) was started. Symptoms disappeared after eight months of oral administration and administration of oral bisphosphonate was finished at that time. In addition, 99m Tc showed a decreased uptake in the left part of the mandible. The patient has been obtained good progress without a recurrence at the present and passed for 65 months on complete remission. Recenly treatment with bisphosphonate of SAPHO patients who is refractory to NSAIDs has been reported2. This report showed that administration of oral bisphosphonate had a dramatic and longstanding effect for a patient of DSOM associated with SAPHO syndrome. Further trials of oral bisphosphonate in patients with DSOM and even in patients with SAPHO syndrome are needed to assess its effectiveness. References: 1. Chamot AM, Benhamou CL, Kahn MF, et al: [Acne-pustulosishyperotosis-osteitis syndrome. Results of a national survey. 85 Cases]. Rev Rhum Mal Osteoartic 54: 187, 1987 2. Hayem G, Bouchaud-Chabot A, Benal K, et al: SAPHO syndrome: A long-term follow-up study of 120 cases. Semin Arthritis Rheum 29:159, 1999
AAOMS 2014