Skip to main content
Top
Published in: Clinical and Experimental Nephrology 3/2014

Open Access 01-06-2014 | Original Article

Safety and efficacy of skin patches containing loxoprofen sodium in diabetic patients with overt nephropathy

Authors: Hisazumi Araki, Shogo Kuwagata, Mariko Soumura, Kosuke Yamahara, Yoshikata Morita, Shinji Kume, Keiji Isshiki, Shin-ichi Araki, Atsunori Kashiwagi, Hiroshi Maegawa, Takashi Uzu

Published in: Clinical and Experimental Nephrology | Issue 3/2014

Login to get access

Abstract

Background

Because oral nonsteroidal anti-inflammatory drugs (NSAIDs) have adverse effects on kidney function, patients with kidney diseases are administered these drugs as transdermal patches. Little is known about the effects of NSAID patches on renal function. We therefore assessed the effects of topical loxoprofen sodium on kidney function in type 2 diabetic patients with overt nephropathy.

Methods

Twenty patients with type 2 diabetes and overt proteinuria and with knee and/or low back pain were treated with skin patches containing 100 mg loxoprofen on the knee or back for 24 h per day for 5 consecutive days. The degree of pain was assessed using a visual analogue scale (VAS). Blood and 24-h urine samples were obtained at baseline and at the end of the study. Glomerular filtration rate (GFR) was estimated from serum creatinine and cystatin C concentrations.

Results

The 20 patients consisted of 11 males and 9 females, of mean age 61.6 ± 13.9 years. Loxoprofen-containing patches significantly reduced VAS pain without affecting blood pressure, GFR or urinary prostaglandin E2 concentration. Serum concentrations of loxoprofen and its active trans-OH metabolite did not correlate with GFR.

Conclusions

Loxoprofen-containing patches do not affect renal function in type 2 diabetic patients with overt nephropathy over a short-term period. Long-term studies are needed to clarify the safety of loxoprofen-containing patches in patients with chronic kidney diseases.
Literature
1.
go back to reference Huerta C, Castellsague J, Varas-Lorenzo C, Garcia Rodriguez LA. Nonsteroidal anti-inflammatory drugs and risk of ARF in the general population. Am J Kidney Dis: Off J Natl Kidney Found. 2005;45(3):531–9.CrossRef Huerta C, Castellsague J, Varas-Lorenzo C, Garcia Rodriguez LA. Nonsteroidal anti-inflammatory drugs and risk of ARF in the general population. Am J Kidney Dis: Off J Natl Kidney Found. 2005;45(3):531–9.CrossRef
2.
go back to reference Nitsch D, Tomlinson LA. Safety of co-prescribing NSAIDs with multiple antihypertensive agents: triple drug combinations are associated with increased hospital admission for acute kidney injury, but questions remain. BMJ. 2013;346:e8713.PubMedCrossRef Nitsch D, Tomlinson LA. Safety of co-prescribing NSAIDs with multiple antihypertensive agents: triple drug combinations are associated with increased hospital admission for acute kidney injury, but questions remain. BMJ. 2013;346:e8713.PubMedCrossRef
4.
go back to reference Fournier JP, Sommet A, Durrieu G, Poutrain JC, Lapeyre-Mestre M, Montastruc JL. Drug interactions between antihypertensive drugs and non-steroidal anti-inflammatory agents: a descriptive study using the French Pharmacovigilance database. Fund Clin Pharmacol 2012. DOI: 10.1111/fcp.12014 Fournier JP, Sommet A, Durrieu G, Poutrain JC, Lapeyre-Mestre M, Montastruc JL. Drug interactions between antihypertensive drugs and non-steroidal anti-inflammatory agents: a descriptive study using the French Pharmacovigilance database. Fund Clin Pharmacol 2012. DOI: 10.1111/fcp.12014
5.
go back to reference Clive DM, Stoff JS. Renal syndromes associated with nonsteroidal antiinflammatory drugs. New Engl J Med. 1984;310(9):563–72.PubMedCrossRef Clive DM, Stoff JS. Renal syndromes associated with nonsteroidal antiinflammatory drugs. New Engl J Med. 1984;310(9):563–72.PubMedCrossRef
6.
go back to reference Garella S, Matarese RA. Renal effects of prostaglandins and clinical adverse effects of nonsteroidal anti-inflammatory agents. Medicine. 1984;63(3):165–81.PubMedCrossRef Garella S, Matarese RA. Renal effects of prostaglandins and clinical adverse effects of nonsteroidal anti-inflammatory agents. Medicine. 1984;63(3):165–81.PubMedCrossRef
7.
go back to reference Carmichael J, Shankel SW. Effects of nonsteroidal anti-inflammatory drugs on prostaglandins and renal function. Am J Med. 1985;78(6 Pt 1):992–1000.PubMedCrossRef Carmichael J, Shankel SW. Effects of nonsteroidal anti-inflammatory drugs on prostaglandins and renal function. Am J Med. 1985;78(6 Pt 1):992–1000.PubMedCrossRef
8.
go back to reference Patrono C, Dunn MJ. The clinical significance of inhibition of renal prostaglandin synthesis. Kidney Int. 1987;32(1):1–12.PubMedCrossRef Patrono C, Dunn MJ. The clinical significance of inhibition of renal prostaglandin synthesis. Kidney Int. 1987;32(1):1–12.PubMedCrossRef
9.
go back to reference Stage classification of diabetic nephropathy: report of the Ministry of Health and Welfare, Japan (in Japanese); 1991 pp. 251–256. Stage classification of diabetic nephropathy: report of the Ministry of Health and Welfare, Japan (in Japanese); 1991 pp. 251–256.
11.
go back to reference Matsuo S, Imai E, Horio M, Yasuda Y, Tomita K, Nitta K, et al. Revised equations for estimated GFR from serum creatinine in Japan. Am J Kidney Dis: Off J Natl Kidney Found. 2009;53(6):982–92.CrossRef Matsuo S, Imai E, Horio M, Yasuda Y, Tomita K, Nitta K, et al. Revised equations for estimated GFR from serum creatinine in Japan. Am J Kidney Dis: Off J Natl Kidney Found. 2009;53(6):982–92.CrossRef
12.
go back to reference Japanese Society of Nephrology ed. Clinical Practice Guidebook for Diagnosis and Treatment of Chronic Kidney Disease 2012. Tokyo: Tokyo igaku sya; 2012. Japanese Society of Nephrology ed. Clinical Practice Guidebook for Diagnosis and Treatment of Chronic Kidney Disease 2012. Tokyo: Tokyo igaku sya; 2012.
13.
go back to reference Naganuma HMY, Kawahara Y. Study of pharmacokinetics following oral administration of loxoprofen sodium (CS-600) in humans. Rinsho Iyaku. 1986;2(9):1219–37. Naganuma HMY, Kawahara Y. Study of pharmacokinetics following oral administration of loxoprofen sodium (CS-600) in humans. Rinsho Iyaku. 1986;2(9):1219–37.
14.
go back to reference Aljadhey H, Tu W, Hansen RA, Blalock SJ, Brater DC, Murray MD. Comparative effects of non-steroidal anti-inflammatory drugs (NSAIDs) on blood pressure in patients with hypertension. BMC Cardiovasc Disord. 2012;12:93.PubMedCentralPubMedCrossRef Aljadhey H, Tu W, Hansen RA, Blalock SJ, Brater DC, Murray MD. Comparative effects of non-steroidal anti-inflammatory drugs (NSAIDs) on blood pressure in patients with hypertension. BMC Cardiovasc Disord. 2012;12:93.PubMedCentralPubMedCrossRef
15.
go back to reference Johnson AG, Simons LA, Simons J, Friedlander Y, McCallum J. Non-steroidal anti-inflammatory drugs and hypertension in the elderly: a community-based cross-sectional study. Br J Clin Pharmacol. 1993;35(5):455–9.PubMedCentralPubMedCrossRef Johnson AG, Simons LA, Simons J, Friedlander Y, McCallum J. Non-steroidal anti-inflammatory drugs and hypertension in the elderly: a community-based cross-sectional study. Br J Clin Pharmacol. 1993;35(5):455–9.PubMedCentralPubMedCrossRef
16.
go back to reference Dedier J, Stampfer MJ, Hankinson SE, Willett WC, Speizer FE, Curhan GC. Non-narcotic analgesic use and the risk of hypertension in US women. Hypertension. 2002;40(5):604–8 discussion 1–3.PubMedCrossRef Dedier J, Stampfer MJ, Hankinson SE, Willett WC, Speizer FE, Curhan GC. Non-narcotic analgesic use and the risk of hypertension in US women. Hypertension. 2002;40(5):604–8 discussion 1–3.PubMedCrossRef
17.
go back to reference Kurth T, Hennekens CH, Sturmer T, Sesso HD, Glynn RJ, Buring JE, et al. Analgesic use and risk of subsequent hypertension in apparently healthy men. Arch Intern Med. 2005;165(16):1903–9.PubMedCrossRef Kurth T, Hennekens CH, Sturmer T, Sesso HD, Glynn RJ, Buring JE, et al. Analgesic use and risk of subsequent hypertension in apparently healthy men. Arch Intern Med. 2005;165(16):1903–9.PubMedCrossRef
18.
go back to reference Solomon DH, Schneeweiss S, Levin R, Avorn J. Relationship between COX-2 specific inhibitors and hypertension. Hypertension. 2004;44(2):140–5.PubMedCrossRef Solomon DH, Schneeweiss S, Levin R, Avorn J. Relationship between COX-2 specific inhibitors and hypertension. Hypertension. 2004;44(2):140–5.PubMedCrossRef
19.
go back to reference Wang J, Mullins CD, Mamdani M, Rublee DA, Shaya FT. New diagnosis of hypertension among celecoxib and nonselective NSAID users: a population-based cohort study. Ann Pharmacother. 2007;41(6):937–43.PubMedCrossRef Wang J, Mullins CD, Mamdani M, Rublee DA, Shaya FT. New diagnosis of hypertension among celecoxib and nonselective NSAID users: a population-based cohort study. Ann Pharmacother. 2007;41(6):937–43.PubMedCrossRef
Metadata
Title
Safety and efficacy of skin patches containing loxoprofen sodium in diabetic patients with overt nephropathy
Authors
Hisazumi Araki
Shogo Kuwagata
Mariko Soumura
Kosuke Yamahara
Yoshikata Morita
Shinji Kume
Keiji Isshiki
Shin-ichi Araki
Atsunori Kashiwagi
Hiroshi Maegawa
Takashi Uzu
Publication date
01-06-2014
Publisher
Springer Japan
Published in
Clinical and Experimental Nephrology / Issue 3/2014
Print ISSN: 1342-1751
Electronic ISSN: 1437-7799
DOI
https://doi.org/10.1007/s10157-013-0850-4

Other articles of this Issue 3/2014

Clinical and Experimental Nephrology 3/2014 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.