Summary
A double-blind, randomised trial was carried out to investigate the relationship between efficacy and various pharmacokinetic variables after single doses of racemic ketoprofen 12.5 and 25mg in patients with postoperative pain after third molar surgery over a 4-hour investigation period. Serial venous blood samples were obtained at 0, 0.25, 0.5, 0.75, 1, 1.5, 2, 3 and 4 hours after administration for subsequent determination of R(−) and S(+) ketoprofen. The relationship between the R(−) and S(+) ketoprofen concentrations and pain experience was summarised for each patient by the slope of the regression line for that individual. There was no significant difference (p > 0.05) between the two doses of ketoprofen for any of the efficacy measures. Peak plasma concentrations of both R(−) and S(+) ketoprofen were observed between 60 and 90 minutes after dosage. A significant negative correlation (p < 0.002) was observed between the decrease in pain scores and plasma concentrations of both R(−) and S(+) ketoprofen after each dose. However, the amount of variability in each patient's response makes it difficult to identify a causal relationship between these parameters. Low doses of ketoprofen provide satisfactory pain relief in the early postoperative period after third molar surgery. Efficacy of this analgesic does not appear to be dose related or directly related to plasma concentrations of either R(−) or S(+) en-antiomers.
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References
Kantor TG.Ketoprofen: review of its pharmacological properties. Pharmacotherapy 1986; 6: 93–103
Cathcart BJ, Vince JD, Gordon AJ, et al. Studies on 2-(3-benzylphenyl) propionic acid (Orudis): a double-blind, crossover trial in patients with rheumatoid arthritis. Ann Rheum Dis 1973; 32: 62–5
Mehlisch DR. Double-blind, cross-over comparison of ketoprofen, naproxen and placebo in patients with primary dysmenorrhea. Clin Ther 1990; 12: 398–409
Seymour RA, Kelly PJ, Hawkesford JE. The comparative efficacy of ketoprofen and paracetamol (acetaminophen) in postoperative pain after third molar surgery. Br J Clin Pharmacol 1996; 41: 581–5
Payan E, Dubois N, Netter P. Protein binding and stereoselectivity on nonsteroidal anti-inflammatory drugs. Clin Pharmacokinet 1993; 25: 115–23
Lasagna L. Analgesic methodology: a brief history and commentary. J Clin Pharmacol 1980; 20: 373–400
Matthews JNS, Altaian DG, Campbell MJ, et al. Analysis of serial measurements in medical research. BMJ 1990; 300: 230–5
Meechan JG, Seymour RA. The use of third molar surgery in clinical pharmacology. Br J Oral Maxillofac Surg 1993; 31: 360–5
Cooper SA, Gelb SB, Goldman EH, et al. An analgesic relative potency assay comparing ketoprofen and aspirin in postoperative dental pain. Adv Ther 1984; 1: 410–8
Mehlisch D, Frakes L, Cavaliere MB, et al. Double-blind parallel comparison of single oral doses of ketoprofen, codeine and placebo in patients with moderate to severe dental pain. J Clin Pharmacol 1984; 24: 486–92
Laska EM, Sunshine A, Marrero I, et al. The correlation between blood levels of ibuprofen and clinical analgesic response. Clin Pharmacol Ther 1986; 40: 1–7
Jones K, Seymour RA, Waltham K, et al. The pharmacokinetics and efficacy of soluble ibuprofen in postoperative pain after third molar surgery. J Dent Res 1990; 69: 278
Evans AM, Nation RL, Sansom LN, et al. Effect of racemic ibuprofen dose on the magnitude and duration of platelet cyclo-oxygenase inhibition: relationship between inhibition of thromboxane production and the plasma unbound concentration of S(+) ibuprofen. Br J Clin Pharmacol 1991; 31: 131–8
Hayball PJ, Nation RL, Bochner F, et al. The influence of renal function on the enantioselective pharmacokinetics and pharmacodynamics of ketoprofen in patients with rheumatoid arthritis. Br J Clin Pharmacol 1993; 36: 185–93
Bannwarth B, Lapicque F, Pehourcq F, et al. Stereoselective disposition of ibuprofen enantiomers in human cerebrospinal fluid. Br J Clin Pharmacol 1995; 40: 266–9
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Seymour, R., Kelly, P. & Hawkesford, J. Pharmacokinetics and Efficacy of Low- Dose Ketoprofen in Postoperative Dental Pain. Clin. Drug Investig. 15, 279–284 (1998). https://doi.org/10.2165/00044011-199815040-00003
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DOI: https://doi.org/10.2165/00044011-199815040-00003