Double‐blind study to evaluate efficacy and safety of meloxicam 7.5 mg and 15 mg versus mefenamic acid 1500 mg in the treatment of primary dysmenorrhea

Mello, Nilson Roberto de; Baracat, Edmund Chada; Tomaz, Geraldez; Bedone, Aloísio José; Camargos, Aroldo F.; Barbosa, Ione Cristina; Souza, Rosival Nassar de; Rumi, Demétrio Ortega; Alcalá, Félix Octavio Martínez; Velasco, Jorge Antonio Aldrete; Cortés, Roberto José Risco

doi:10.1111/j.0001-6349.2004.00433.x

Cited by 17 publications

(10 citation statements)

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“…As a result, we retrieved 121 publications with full length into systematic review and included 70 studies with 72 RCTs of 5723 patients into our network meta-analysis due to the selection criteria as shown earlier. 11 , 12 , 14 – 81 The flowchart of the whole process is shown in…”

Section: Resultsmentioning

confidence: 99%

Comparison of the efficacy and safety of non-steroidal anti-inflammatory drugs for patients with primary dysmenorrhea: A network meta-analysis

Feng

Wang

2018

Mol Pain

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ObjectiveNon-steroidal anti-inflammatory drugs are used as first-line treatment of primary dysmenorrhea, but there has been no optimal clinical choice among non-steroidal anti-inflammatory drugs yet. The present study was to assess the relative benefits of different common non-steroidal anti-inflammatory drugs for primary dysmenorrhea patients with a network meta-analysis.MethodsRandomized controlled trials were screened by our criteria and included in the network meta-analysis. Pain relief was considered as primary outcomes and adverse effect was supplied as a safety outcome, while additional rescue, assessment score, and pain intensity difference were secondary outcomes. All the indexes were evaluated with odds ratio or standardized mean difference. Surface under cumulative ranking curve result was used to calculate the ranking of each treatment.ResultsTotally, 72 randomized controlled trials of 5723 patients and 13 drugs were included in our study after screening. As for pain relief, all drugs except nimesulide, rofecoxib, and waldecoxib were superior to aspirin (odds ratio with 95% credible intervals, diclofenac: 0.28 (0.08, 0.86), flurbiprofen: 0.10 (0.03, 0.29), ibuprofen: 0.32 (0.14, 0.73), indomethacin: 0.21 (0.07, 0.58), ketoprofen: 0.25 (0.10, 0.64), mefenamic acid: 0.28 (0.09, 0.87), naproxen: 0.31 (0.15, 0.64), piroxicam: 0.15 (0.03, 0.59), and tiaprofenic acid: 0.17 (0.04, 0.63)). Aspirin also required additional rescue when compared with the majority of other drugs (flurbiprofen: 3.46 (1.15, 11.25), ibuprofen: 6.30 (2.08, 20.09), mefenamic acid: 7.32 (1.51, 37.71), naproxen: 2.66 (1.17, 6.55), and tiaprofenic acid: 9.58 (1.43, 94.63)). As for assessment of the whole treatment, ketoprofen, naproxen, rofecoxib, and ibuprofen got higher score significantly than placebo. In addition, ibuprofen performed better than placebo in pain intensity difference. Considering the safety, tiaprofenic acid and mefenamic acid were noticeable in low risk, and indomethacin revealed higher risk than any other drugs. According to the results of network analysis and surface under cumulative ranking curve, flurbiprofen was considered to be the best one among all the treatments in efficacy, and aspirin was worse than most of others. On the other hand, tiaprofenic acid and mefenamic acid were indicated as the safest drugs.ConclusionConsidering the efficacy and safety, we recommended flurbiprofen and tiaprofenic acid as the optimal treatments for primary dysmenorrhea.

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Section: Resultsmentioning

confidence: 99%

Comparison of the efficacy and safety of non-steroidal anti-inflammatory drugs for patients with primary dysmenorrhea: A network meta-analysis

Feng

Wang

2018

Mol Pain

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“…Mello et al compared the effectiveness of using 500 mg mefenamic acid tablets 3 times a day, meloxicam 7.5 mg tablets once a day and 15 mg meloxicam tablets once a day for patients complaining of primary dysmenorrhea, and they also investigated the safety and efficiency of these treatments [3]. The 10 cm VAS was used as an evaluation scale and at the beginning of their study, and the patients who had a VAS score greater than 3.5 were accepted.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, NSAIDs are generally used for dysmenorrhea treatment [2]. Generally, tablet forms of the medications are used in studies that have focused on NSAID usage for dysmenorrhea treatment [3–5]. However, we have observed that parenteral treatment for patients who are admitted to emergency units complaining of strong pain is more comfortable, fast, and effective.…”

Section: Introductionmentioning

confidence: 99%

Comparison of the Effects of Piroxicam and Diclofenac Sodium as Treatments for Primary Dysmenorrhea

et al. 2019

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BackgroundNSAIDs are the most common agents used in dysmenorrhea treatment. They reduce menstrual pain by reducing uterine pressure and PGF2alpha levels in the menstrual fluid. The aim of this study was to compare the effects of piroxicam and diclofenac sodium as treatments for primary dysmenorrhea.Material/MethodsThe study was conducted using a randomized and double-blind method. Patients with Visual Analogue Scale (VAS) scores greater than 5 were accepted into the study. The patients who were suitable for inclusion were randomized into 2 groups and received either intramuscular piroxicam or diclofenac sodium. The patients’ pain levels were measured at baseline and at 15, 30, 45, and 60 min. A VAS of 10 cm, a numeric scale, a verbal scale, and additional symptoms, as well as pain relapse after 24 hours and required analgesics, were recorded.ResultsThe study included 400 patients. Overall, 200 patients (50%) were in the proxicam group, and 200 patients were in the diclofenac sodium group. The average decrease on the VAS after piroxicam or diclofenac administration was measured as 7.9±1.8 cm and 7.9±1.7 cm (median ± standard deviation), respectively. The pain-reducing efficiency of all the treatments was compared using the Mann-Whitney U test (p=0.929). Rescue medication was needed for 25 patients in the proxicam group (p=0.014). Overall, 30 patients in the proxicam group and 41 patients in the proxicam group needed analgesics again in the 24-hour period after treatment (p=0.150).ConclusionsAt the end of our study, it was observed that there was no difference in the results of primary dysmenorrhea treatment with 20 mg piroxicam or 75 mg diclofenac sodium.

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“…This serious complication has not been reported in many trials using cycling regimens in the treatment of menorrhagia and dysmenorrhea even though the medication was used for more than 1 year. [ 23 – 26 ] Furthermore, diarrhea was reported in only 3% of patients with acute mefenamic acid overdosage. [ 27 ] The lag of the occurrence of symptoms after the initiation of the drug may have caused failure to recognize its causative role.…”

Section: Discussionmentioning

confidence: 99%

Severe enteropathy with villous atrophy in prolonged mefenamic acid users – a currently under-recognized in previously well-recognized complication

Kaosombatwattana¹,

Limsrivilai²,

Pongpaibul

et al. 2017

Medicine

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Double‐blind study to evaluate efficacy and safety of meloxicam 7.5 mg and 15 mg versus mefenamic acid 1500 mg in the treatment of primary dysmenorrhea

Abstract: Both of the daily doses of meloxicam tested were comparable to 500 mg mefenamic acid t.i.d. in relieving dysmenorrhea symptoms, and meloxicam seems to have a better gastrointestinal tolerability profile.

Cited by 17 publications

References 35 publications

Comparison of the efficacy and safety of non-steroidal anti-inflammatory drugs for patients with primary dysmenorrhea: A network meta-analysis

Comparison of the efficacy and safety of non-steroidal anti-inflammatory drugs for patients with primary dysmenorrhea: A network meta-analysis

Comparison of the Effects of Piroxicam and Diclofenac Sodium as Treatments for Primary Dysmenorrhea

Severe enteropathy with villous atrophy in prolonged mefenamic acid users – a currently under-recognized in previously well-recognized complication

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