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Latest & greatest articles for ibuprofen
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Prophylactic ibuprofen versus placebo in very premature infants: a randomised, double-blind, placebo-controlled trial. Patent ductus arteriosus is a common complication of prematurity that frequently requires surgical or medical treatment. The benefit of prophylactic treatment by indometacin, a cyclo-oxygenase inhibitor, remains uncertain compared with curative treatment. This benefit could be improved with ibuprofen, another cyclo-oxygenase inhibitor with fewer adverse effects than indometacin (...) on renal, mesenteric, and cerebral perfusion. We aimed to compare prophylactic and curative ibuprofen in the treatment of this abnormality in very premature infants.We did a randomised controlled trial in infants younger than 28 weeks of gestation, who were randomly assigned to receive either three doses of ibuprofen or placebo within 6 h of birth. After day 3, symptomatic patent ductus arteriosus was treated first by open curative ibuprofen, then back-up indometacin, surgery, or both. The primary
2004LancetControlled trial quality: predicted high
Prophylactic ibuprofen in premature infants: a multicentre, randomised, double-blind, placebo-controlled trial. Ibuprofen is used for treatment and prevention of patent ductus arteriosus in low-birthweight infants. Its effects on regional circulations differ from those of indometacin. Because prophylactic indometacin reduces the frequency of severe intraventricular haemorrhage and patent ductus arteriosus, we aimed to study the efficacy of early ibuprofen in reducing these outcomes in a double (...) -blind, multicentre trial.Within 6 h after birth, 415 low-birthweight infants (gestational age <31 weeks) were randomly allocated ibuprofen-lysine (10 mg/kg then two doses of 5 mg/kg after 24 h and 48 h) or placebo intravenously. The primary outcome was occurrence of severe intraventricular haemorrhage; secondary outcomes were occurrence of patent ductus arteriosus and possible adverse effects of ibuprofen. Analysis was by intention to treat.17 (8%) of 205 infants assigned ibuprofen and 18 (9
2004LancetControlled trial quality: predicted high
Comparison of lumiracoxib with naproxen and ibuprofen in the Therapeutic Arthritis Research and Gastrointestinal Event Trial (TARGET), reduction in ulcer complications: randomised controlled trial. Cyclo-oxygenase 2 (COX2)-selective inhibitors should reduce ulcer complications compared with non-selective non-steroidal anti-inflammatory drugs, but evidence is limited, and the possibility that these inhibitors increase cardiovascular events has been raised. The Therapeutic Arthritis Research (...) and Gastrointestinal Event Trial (TARGET) aimed to assess gastrointestinal and cardiovascular safety of the COX2 inhibitor lumiracoxib compared with two non-steroidal anti-inflammatory drugs, naproxen and ibuprofen.18325 patients age 50 years or older with osteoarthritis were randomised to lumiracoxib 400 mg once daily (n=9156), naproxen 500 mg twice daily (4754), or ibuprofen 800 mg three times daily (4415) for 52 weeks, in two substudies of identical design (lumiracoxib vs ibuprofen or naproxen). Randomisation
2004LancetControlled trial quality: predicted high
Comparison of lumiracoxib with naproxen and ibuprofen in the Therapeutic Arthritis Research and Gastrointestinal Event Trial (TARGET), cardiovascular outcomes: randomised controlled trial. The potential for cyclo-oxygenase 2 (COX2)-selective inhibitors to increase the risk for myocardial infarction is controversial. The Therapeutic Arthritis Research and Gastrointestinal Event Trial (TARGET) aimed to assess gastrointestinal and cardiovascular safety of the COX2 inhibitor lumiracoxib compared (...) with two non-steroidal anti-inflammatory drugs, naproxen and ibuprofen.18325 patients age 50 years or older with osteoarthritis were randomised to lumiracoxib 400 mg once daily (n=9156), naproxen 500 mg twice daily (4754), or ibuprofen 800 mg three times daily (4415) in two substudies of identical design. Randomisation was stratified for low-dose aspirin use and age. The primary cardiovascular endpoint was the Antiplatelet Trialists' Collaboration endpoint of non-fatal and silent myocardial infarction
2004LancetControlled trial quality: predicted high
Is indomethacin or ibuprofen better for medical closure of the patent ductus arteriosus? BestBets: Is ibuprofen or indomethacin better for medical closure of the patent ductus arterious? Is ibuprofen or indomethacin better for medical closure of the patent ductus arterious? Report By: Erik N Swartz - Pediatric Cardiology Fellow Institution: University of Alberta, Edmonton, Canada Date Submitted: 10th March 2003 Date Completed: 15th July 2004 Last Modified: 15th July 2004 Status: Green (complete (...) ) Three Part Question In [a preterm baby of gestational age less than or equal to 34 weeks] is [ibuprofen compared with indomethacin] equally efficacious at [treating echocardiographically proven patent ductus arteriosus and have fewer side effects]? Clinical Scenario A preterm baby of 28 weeks gestation with respiratory distress syndrome is admitted to the neonatal intensive care unit. On day 2 of life, the characteristic murmur or a patent ductus arteriosus (PDA) is heard, with the diagnosis
Effect of ibuprofen on cardioprotective effect of aspirin. Treatment with ibuprofen might limit the cardioprotective effects of aspirin. We aimed to assess whether patients with known cardiovascular disease who take low-dose aspirin and ibuprofen have increased risk of cardiovascular mortality. We studied 7107 patients who were discharged after first admission for cardiovascular disease between April, 1989, and April, 1997, and who were prescribed low-dose aspirin (<325 mg/day) and survived (...) for at least 1 month. Compared with those who used aspirin alone, patients taking aspirin plus ibuprofen had an increased risk of all-cause mortality (adjusted hazard ratio 1.93, 95% CI 1.30-2.87, p=0.0011) and cardiovascular mortality (1.73, 1.05-2.84, p=0.0305). Our finding lends support to the hypothesis that ibuprofen may interact with the cardioprotective effects of aspirin, at least in patients with established cardiovascular disease.
Ibuprofen for Alzheimer's disease. Non-steroidal antiinflammatory drugs such as ibuprofen may have a role in the treatment of conditions characterized by inflammatory processes. Ibuprofen may attenuate the effects of modulators of inflammation that have been implicated in the pathogenesis of Alzheimer's disease.To investigate the efficacy of ibuprofen treatment for people with Alzheimer's disease.The trials were identified from a search of the Specialized Register of the Cochrane Dementia (...) and Cognitive Improvement Group on 10 December 2002 using the (many) terms listed in the main text of the review. The CDCIG Register is updated regularly and contains records from all major health care databases and many ongoing trials databases. In addition computerized databases and Internet sites pertaining to ibuprofen and Alzheimer's disease were systematically examined by two reviewers independently. Data on ongoing trials of ibuprofen for the treatment of people with AD were also sought.Eligibility
Ibuprofen for the treatment of a patent ductus arteriosus in preterm and/or low birth weight infants. A patent ductus arteriosus (PDA) complicates the clinical course of preterm infants, increasing their risks of developing chronic lung disease (CLD), necrotizing enterocolitis (NEC), and intraventricular hemorrhage (IVH). Indomethacin is used as standard therapy to close a PDA, but is associated with reduced blood flow to the brain, kidneys and gut. Ibuprofen, another cyclo-oxygenase inhibitor (...) , may be as effective with fewer side effects.To determine the effectiveness and safety of ibuprofen compared to placebo or no intervention for closing a PDA in preterm and/or low birth weight infants. To determine the effectiveness and safety of ibuprofen compared to other cyclo-oxygenase inhibitors (including indomethacin, mefenamic acid) for closing a PDA in preterm and/or low birth weight infants.Randomized (or quasi-randomized) controlled trials (RCTs) comparing ibuprofen to placebo
Ibuprofen 400 mg is effective in women, and women are well represented in trials Ibuprofen 400 mg is effective in women, and women are well represented in trials Ibuprofen 400 mg is effective in women, and women are well represented in trials Barden J, Edwards J E, Moore R A, McQuay H J Authors' objectives To investigate whether women have been under-represented in trials of ibuprofen and whether there is a clinically meaningful difference between men and women in the efficacy of ibuprofen 400 (...) trials (RCTs) that were double-blind were eligible for inclusion. The review included summary data and IPD, where available. Specific interventions included in the review Studies comparing ibuprofen with placebo were eligible for inclusion. The included studies used a 400-mg single dose of ibuprofen. Participants included in the review Adult patients with moderate or severe post-operative pain were eligible for inclusion. The majority of the included studies were of patients having a third molar
Glucosamine therapy compared to ibuprofen for joint pain Glucosamine therapy compared to ibuprofen for joint pain Glucosamine therapy compared to ibuprofen for joint pain Ruane R, Griffiths P Authors' objectives To undertake a mini-review of double-blind randomised controlled trials (RCTs) comparing the effectiveness of oral glucosamine to ibuprofen for the relief of joint pain in osteoarthritis. Searching MEDLINE (from 1966 to present), EMBASE (from 1980 to present), a database provided (...) Comparisons of an oral glucosamine preparation with a standard dose of ibuprofen were eligible for inclusion. Trials that studied glucosamine in sulphate or hydrochloride form were included since the available preparations contain either substance. Studies that assessed intramuscular glucosamine were excluded. Trials that compared glucosamine to any other non-steroidal anti-inflammatory drug or placebo were also excluded, as were trials that examined glucosamine in addition to other analgesics. Trials
Pulmonary hypertension after ibuprofen prophylaxis in very preterm infants. We report three cases of severe hypoxaemia after ibuprofen administration during a randomised controlled trial of prophylactic treatment of patent ductus arteriosus with ibuprofen in premature infants born at less than 28 weeks of gestation. Echocardiography showed severely decreased pulmonary blood flow. Hypoxaemia resolved quickly on inhaled nitric oxide therapy. We suggest that investigators involved in similar (...) trials pay close attention to pulmonary pressure if hypoxaemia occurs after prophylactic administration of ibuprofen.
Treating fever in children: paracetamol or ibuprofen? Treating fever in children: paracetamol or ibuprofen? Treating fever in children: paracetamol or ibuprofen? Purssell E Authors' objectives To compare the effectiveness of paracetamol and ibuprofen as antipyretic medications for children. Searching MEDLINE, EMBASE, CINAHL and the Royal College of Nursing database were searched from 1970. The keywords used were ('children' or 'infants' or 'paediatric' or 'pediatric') and ('fever' or 'febrile (...) ' or 'pyrexia' or ' temperature') and ('paracetamol' or 'acetaminophen') and 'ibuprofen'. Textbooks and reference lists were also searched. Study selection Study designs of evaluations included in the review Studies that reported sufficient statistics to allow the calculation of effect size were eligible. The included studies were randomised controlled trials (RCTs), including double-blind RCTs, and controlled trials in which it was unclear whether they were randomised or not. Specific interventions
Safety profile of nonprescription ibuprofen in the elderly osteoarthritis patient: a meta-analysis Safety profile of nonprescription ibuprofen in the elderly osteoarthritis patient: a meta-analysis Safety profile of nonprescription ibuprofen in the elderly osteoarthritis patient: a meta-analysis Ashraf E, Cooper S, Kellstein D, Jayawardena S Authors' objectives To assess the incidence of adverse experiences among elderly people taking multiple doses of non-prescription ibuprofen (...) in the review Studies had to have at least one treatment group assigned multiple doses of a marketed formulation of ibuprofen for the symptomatic treatment of osteoarthritis. The eligible treatment regimens were 1,200 mg or less per day for 10 days or less (i.e. regimens within the U.S. non-prescription limits). In the included studies 400 mg of ibuprofen was taken three times a day for 3, 6 or 10 days. All of the trials were placebo-controlled. Participants included in the review Studies in people
A comparison of ibuprofen and indomethacin for closure of patent ductus arteriosus. Indomethacin is the conventional treatment for hemodynamically important patent ductus arteriosus in preterm infants. However, its use is associated with various side effects. In a prospective study, we compared ibuprofen and indomethacin with regard to efficacy and safety for the early treatment of patent ductus arteriosus in preterm infants.We studied 148 infants (gestational age, 24 to 32 weeks) who had (...) the respiratory distress syndrome and an echocardiographically confirmed, hemodynamically important patent ductus arteriosus. The infants were randomly assigned at five neonatal intensive care centers to receive three intravenous doses of either indomethacin (0.2 mg per kilogram of body weight, given at 12-hour intervals) or ibuprofen (a first dose of 10 mg per kilogram, followed at 24-hour intervals by two doses of 5 mq per kilogram each), starting on the third day of life. The rate of ductal closure
Single dose oral ibuprofen and diclofenac for postoperative pain. Ibuprofen and diclofenac are two widely used non-steroidal anti-inflammatory (NSAID) analgesics. It is therefore important to know which drug should be recommended for postoperative pain relief. This review seeks to compare the relative efficacy of the two drugs, and also considers the issues of safety and cost.To assess the analgesic efficacy of ibuprofen and diclofenac in single oral doses for moderate to severe postoperative (...) allocation to treatment groups which compared either ibuprofen or diclofenac with placebo.Data were extracted by two independent reviewers, and trials were quality scored. Summed pain relief or pain intensity difference over four to six hours was extracted, and converted into dichotomous information yielding the number of patients with at least 50% pain relief. This was then used to calculate the relative benefit and the number-needed-to-treat (NNT) for one patient to achieve at least 50% pain
The safety profile of nonprescription ibuprofen in multiple-dose use: a meta-analysis The safety profile of nonprescription ibuprofen in multiple-dose use: a meta-analysis The safety profile of nonprescription ibuprofen in multiple-dose use: a meta-analysis Kellstein D E, Waksman J A, Furey S A, Binstok G, Cooper S A Authors' objectives To compare the incidence of adverse experiences during the multiple-dose use of non-prescription ibuprofen to a placebo. Searching MEDLINE, EMBASE, BIOSIS (...) ). Specific interventions included in the review Multiple doses of a marketed formulation of racemic ibuprofen, within over the counter (OTC) limits - up to 1200mg/day for a maximum of 10 days, for conditions appropriate for a non-prescription analgesic/antipyretic. Six studies used 1200mg/day and 2 used 800mg/day. Participants included in the review Participants were aged 12-97 with a mean age of 47, 43% male and 86% Caucasian, 9% black, 1% Asian and 4% Hispanic. Outcomes assessed in the review
Analgesic efficacy of ibuprofen alone and in combination with codeine or caffeine in post-surgical pain: a meta-analysis Analgesic efficacy of ibuprofen alone and in combination with codeine or caffeine in post-surgical pain: a meta-analysis Analgesic efficacy of ibuprofen alone and in combination with codeine or caffeine in post-surgical pain: a meta-analysis Li Wan Po A, Zhang W Y Authors' objectives To estimate the analgesic effect of ibuprofen, and to test whether codeine and caffeine (...) were included. The observation period ranged from 3 to 10 hours. Specific interventions included in the review Oral formulations of ibuprofen, ibuprofen plus codeine, ibuprofen plus caffeine, and placebo. Ibuprofen doses ranged from 50 to 900 mg, codeine from 15 to 60 mg, and caffeine from 50 to 200 mg. Participants included in the review Adults with mild to severe pain resulting from dental, episiotomy, postpartum and other post-operative pain. Patients in eligible ibuprofen and caffeine trials
The effects of ibuprofen on the physiology and survival of patients with sepsis. The Ibuprofen in Sepsis Study Group. In patients with sepsis the production of arachidonic acid metabolites by cyclooxygenase increases, but the pathophysiologic role of these prostaglandins is unclear. In animal models, inhibition of cyclooxygenase by treatment with ibuprofen before the onset of sepsis reduces physiologic abnormalities and improves survival. In pilot studies of patients with sepsis, treatment (...) with ibuprofen led to improvements in gas exchange and airway mechanics.From October 1989 to March 1995, we conducted a randomized, double-blind, placebo-controlled trial of intravenous ibuprofen (10 mg per kilogram of body weight [maximal dose, 800 mg], given every six hours for eight doses) in 455 patients who had sepsis, defined as fever, tachycardia, tachypnea, and acute failure of at least one organ system.In the ibuprofen group, but not the placebo group, there were significant declines in urinary
Early ibuprofen administration to prevent patent ductus arteriosus in premature newborn infants. To test whether early postnatal (0 to 3 hours) intravenous administration of ibuprofen will prevent patent ductus arteriosus (PDA) in preterm neonates.Prospective sequential controlled trial with three treatment arms.Level 3 perinatal-neonatal intensive care nursery.Thirty-four premature newborn infants born from February to August 1993 with a mean birth weight of 913 g (range, 565 to 1460 g (...) ) and gestational age of 26.9 weeks (range, 22.4 to 31.0).Infants were consecutively assigned within 3 hours of age to treatment with either one dose of ibuprofen lysine (10 mg/kg intravenously) followed by 5 mg/kg per dose intravenously at 24 and 48 hours of age (n = 12), one dose of ibuprofen lysine (10 mg/kg intravenously; n = 11), or saline (n = 11).Primary outcome variable was the presence of ductus arteriosus by echocardiography and clinical assessments at 3, 7, and 21 days of life. Secondary outcome