Interaction between Nabumetone – a New Non-Steroidal Anti-Inflammatory Drug – and the Haemostatic System ex vivo

Balla, S. Al; Momen, Abdulkareem Al; Arfaj, H. Al; Sugair, S. Al; Gader, A. M. A.

doi:10.1159/000216138

Cited by 8 publications

(4 citation statements)

References 5 publications

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“…Al Balla et al ,7 studying the effect of nabumetone on platelet aggregation in healthy subjects, could not demonstrate significant differences in platelet aggregation induced by higher concentrations of collagen. It is well known that raising the concentration of collagen can compensate reduction in platelet aggregation by COX inhibitors 4…”

Section: Discussionmentioning

confidence: 92%

Effects of nabumetone compared with naproxen on platelet aggregation in patients with rheumatoid arthritis

Knijff-Dutmer

Martens

Laar

1999

Annals of the Rheumatic Diseases

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Objective-To test the hypothesis that nabumetone (a partially selective cyclooxygenase-(COX)-2 inhibitor) has less effect on platelet aggregation than naproxen (a non-selective COX-inhibitor) in patients with rheumatoid arthritis (RA). Methods-A crossover study in 10 RA patients was performed, using either nabumetone or naproxen for two weeks, and, after a washout period of two weeks, the other drug during another two weeks. Platelet aggregation studies were performed and bleeding time was assessed before and after each treatment period. Results-Maximum platelet aggregation induced by epinephrine and by collagen was significantly more reduced after the use of naproxen than of nabumetone; secondary aggregation induced by ADP and epinephrine disappeared more often by naproxen than by nabumetone. Bleeding times were not influenced. Conclusion-COX dependent platelet aggregation in RA patients seems to be more inhibited by naproxen than by nabumetone. This may be relevant for patients requiring non-steroidal anti-inflammatory drug treatment but who have an increased risk of bleeding as well.

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Section: Discussionmentioning

confidence: 92%

Effects of nabumetone compared with naproxen on platelet aggregation in patients with rheumatoid arthritis

Knijff-Dutmer

Martens

Laar

1999

Annals of the Rheumatic Diseases

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“…In patients with upper or lower GI bleeding, 80% had evidence of impaired platelet prostaglandin synthesis, suggesting recent NSAID use 7 . In contrast, nabumetone has not been shown to inhibit platelet aggregation greatly or to prolong bleeding times 18 –21 …”

Section: Discussionmentioning

confidence: 99%

“…The incidence of perforations, ulcers and bleeds in pooled comparative clinical trials was 0.03% at 6 months 15 . Since nabumetone has been shown to have little or no effect on platelet aggregation and bleeding times, 18 –21 we investigated the incidence of bleeding events and the incidence of serious bleeding leading to withdrawal from the study and/or hospitalization, as well as the incidence of complicated or uncomplicated ulcers, in two comparative studies of efficacy in patients with osteoarthritis.…”

Section: Introductionmentioning

confidence: 99%

Safety and efficacy of nabumetone in osteoarthritis: emphasis on gastrointestinal safety

Scott

Palmer²

2000

Aliment Pharmacol Ther

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The results suggest that nabumetone was similar in efficacy by most criteria to diclofenac SR and piroxicam in relieving the symptoms of osteoarthritis; however, nabumetone's GI safety profile was generally superior to that of both comparator NSAIDs. In the pooled analysis, nabumetone was associated with a significantly lower total incidence of ulcers and bleeding events, and a significantly lower incidence of complications associated with these events.

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“…The safety of nabumetone during arthroscopic surgery and its lack of effect on skin bleeding time suggests that nabumetone may prove safe in this setting 6 –10 . Patients already taking nabumetone may not need to stop taking the drug prior to lower endoscopy, and patients taking aspirin or other NSAIDs may be offered nabumetone as an alternative to acetaminophen prior to lower endoscopy.…”

Section: Introductionmentioning

confidence: 99%

Effect of nabumetone and aspirin on colonic mucosal bleeding time

Basson

Panzini

Palmer³

2001

Aliment Pharmacol Ther

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Although evidence that aspirin and NSAIDs increase the risk of signi®cant bleeding after colonic polypectomy is lacking, aspirin prolongs colonic mucosal bleeding and NSAID use predisposes to minor bleeding after upper or lower endoscopy and biopsy or polypectomy. 1±3 The rate of major bleeding in the latter study was too low to assess an NSAID effect.Concerns about bleeding after polypectomy in aspirin or NSAID users have prompted three strategies. First, dermal bleeding times are used to screen patients before signi®cant polypectomy. However, bleeding times in the colonic mucosa (`endoscopic bleeding time') may not correlate with skin bleeding times in NSAID users. 2 Second, endoscopy is performed during NSAID use and patients with lesions are asked to cease NSAIDs before a second endoscopy for biopsy or polypectomy. In a population at high risk for lesions, this may be uncomfortable, expensive, and complication-prone. Third, all patients are asked to stop aspirin and NSAIDs 1±2 weeks in advance, engendering considerable discom®ture in patients who require NSAIDs for analgesia. NSAIDs with little effect on platelet function in vivo provide a potentially attractive alternative as a bridge to and through endoscopy. Such NSAIDs would include nabumetone, which has insuf®cient effect on thromboxane synthesis in vivo (COX-1 mediated) to substantially affect platelet aggregation, and selective COX-2 inhibitors, which do not affect COX-1 at therapeutic SUMMARY Background: The management of patients taking aspirin or non-steroidal anti-in¯ammatory drugs (NSAIDs) who require colonoscopy remains controversial because of concerns over bleeding after biopsy or polypectomy. Aim: To determine whether patients using the NSAID nabumetone, a non-acidic prodrug with mixed activity against cyclooxygenase-1 (COX-1) and COX-2, exhibited prolonged mucosal bleeding times and how this might compare with mucosal bleeding times in patients using aspirin. Methods: We assessed triplicate mucosal bleeding times in patients undergoing screening¯exible sigmoidoscopy. We compared 90 patients who had taken no aspirin or NSAIDs within the previous 2 weeks, to 60 patients

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Interaction between Nabumetone – a New Non-Steroidal Anti-Inflammatory Drug – and the Haemostatic System ex vivo

Cited by 8 publications

References 5 publications

Effects of nabumetone compared with naproxen on platelet aggregation in patients with rheumatoid arthritis

Effects of nabumetone compared with naproxen on platelet aggregation in patients with rheumatoid arthritis

Safety and efficacy of nabumetone in osteoarthritis: emphasis on gastrointestinal safety

Effect of nabumetone and aspirin on colonic mucosal bleeding time

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