Movalis Review Article
Movalis (more known as Mobic) (generic name: meloxicam) is in a class of drugs called nonsteroidal anti-inflammatory drugs (NSAIDs) and are used to treat pain and/or inflammation.
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Movalis: The Best Way to stop the Pain
The second half of the 20th century was marked by the appearance of a huge number of active non-steroidal anti-inflammatory drugs (NSAIDs). This group of drugs enabled physicians to personalize treatment. The condition of patients with chronic diseases of joints and spine was significantly improved together with the quality of their life. But, by the mid ‘80s, it became obvious that the systematic use of NSAIDs is accompanied by numerous side effects. Therefore the high therapeutic anti-inflammatory effect of the NSAIDs was counteracted by their adverse reactions (V.A. Nanosova, 2001).
A major achievement of the 20th century was the discovery of the mechanism of NSAIDs. It was subsequently shown that there is an "induced" form of the enzyme cyclooxygenase, i.e. cyclooxygenase-2 (COX-2) which, despite the similarity with the cyclooxygenase-1 (COX-1) has different structure and it is encoded by another gene (Needleman P., Isokson P., 1997)
The discovery of two different isoforms of this enzyme has led to speculation which related the therapeutic effect of NSAIDs to the inhibition of COX-2 and the adverse effects to the inhibition of COX-1. COX-1 is responsible for the synthesis of prostaglandins that regulate the physiological activity of cells and COX-2 is responsible for the synthesis of prostaglandins that cause pain, fever and inflammation (Vane J., 1994)
One of the best NSAID drugs is Movalis, also known as Mobic and which has the generic name meloxicam. Movalis selectively acts more upon COX-2 than upon COX-1.
Clinical efficacy was studied in more than 230 clinical trials that involved more than 30,000 patients. These studies showed that the Movalis treatment had a very high therapeutic effect and that it was much safer than other drugs of this kind. The effect was observed on patients suffering from osteoarthritis and chronic inflammatory diseases (with the dosage of 7, 5 mg daily and respectively, 15 mg)
One of the studies was performed in order to observe the clinical efficiency and tolerability of Movalis in the treatment of acute pain in the lower back region (Guzeeva et al. 2004).
Diclofenac was chosen for comparison as the most popular pain reliever for that particular pain. There were not prescribed any other medication and physical therapy for patients. Treatment was conducted in an outpatient setting. The first study group comprised of 40 patients and was treated with Movalis (15 mg a day). The control group included 38 patients who were treated for 6 days with Diclofenac (75 mg a day).
The average age of patients in the study group was 43, 1 ± 12 years and in the control group 42, 4 ± 6 years. There were 37% male and 63% women in the study group and 43% male and 57% female in the control group.
The results of the survey showed that:
• 92% of patients, who underwent the Movalis treatment, felt a clear analgesic effect.
• 33,3 % of the patients in the study group reported that the pain disappeared completely.
• In the control group, none of the patients reported that they didn’t feel any pain after the Diclofenac treatment.
• 96% patients, who underwent Movalis treatment, reported no side effects.
• 69% of patients treated with diclofenac no side effects.
• None of the patients receiving Movalis suffered any severe complications of the gastrointestinal tract.
• In one case of Diclofenac treatment severe complications of the gastrointestinal tract were observed.
• 3 patients who underwent Diclofenac treatment had to stop it.
It’s very important to observe the efficiency and tolerability of Movalis in older patients with rheumatic diseases. A 4-week study on patients with rheumatic diseases (average age was 70 years) and moderate renal impairment didn’t show significant changes in creatinine clearance or increase in creatinine, urea and serum potassium. Moreover, it proved to be very efficient (Bevis et al., 1996).
One more study provided the results for the long-term treatment with Movalis. A number of 357 patients with pseudorheumatism took 15 g of Movalis daily for 18 months. The positive effects such as reduced joint pain while moving, reduced nocturnal joint pain, and morning stiffness was observed in the majority of patients (Huskisson et al., 1996).
Another study, conducted by E.G. Zvetkova, showed that Movalis is the safest and the most efficient drug of all NSAIDs (Zvetkova, 2001).
Another study dedicated to observing the efficacy and safety of was conducted by Odinak M.M., Emelin A.U. Movalis treatment was conducted on a group of 30 people (20 men and 10 women) aged between 20 and 88 years. Patients were divided into two groups. The first group (22 patients) consisted of patients with vertebragenic pain and muscular-tonic syndromes. In the second group (8 persons) the cause of pain was herniated inter-vertebral discs with compression radicular syndromes. The presence of herniated disc was confirmed by magnetic resonance imaging (MRI). The duration of disease varied considerably from 1 to 29 years while the average was about 10 years. The duration of pain exacerbation prior to the administration of Movalis was about 10-12 days.
The results were the following:
• The efficiency of Movalis was observed in 86, 7% of patients.
• Patients with reflex pain and muscular-tonic syndromes reported good analgesic effect after 3 days of Movalis treatment.
• The best efficacy of the drug was reached after 8-10 days of administration.
• In patients with discogenic compressive radicular syndromes, significant analgesic effect was achieved within a week of Movalis treatment.
• Side effects were observed only in 10% of patients. They were slightly expressed and did not require the change of dose or use of additional therapy. Movalis has good local and general tolerability (Odinak M.M, Emelin A.U., 2004).
Both the above mentioned studies as well as numerous other materials show that Movalis can be the best drug in treating patients suffering from different rheumatic diseases. Also, patients who, apart from joint disease, have the pathology of cardiovascular system, liver, or kidneys, reported the efficiency of Movalis treatment. Movalis, in a dose of 7.5 mg, may indeed be the first choice in drugs for patients over 65 years.
In conclusion, it should be noted that the use of selective COX-2 inhibitors, primarily Movalis, can improve the efficiency of a number of rheumatic diseases, make a less dangerous combination therapy for patients suffering from multiple pathological processes. It is particularly important that there is evidence for the possible prevention and treatment of not only rheumatic, but also other common human diseases using the Movalis treatment (Nanosova, 2001).
Nanosova V.A. (2001), “Non-steroid anti-inflammatory drugs (perspectives of use in medicine)”, Moscow, Russia, p.143.
Needleman P. and Isokson P.(1997) , “Rheumatology”, New York, USA, pp. 6-8.
Vane J. (1994), “Nature”, Tardebigg, Worcestershire, pp. 215-216.
Bevis, M., S. Businger, T. A. Herring, C. Rocken, R. A. Anthes, and R. H. Ware,(1996), GPS meteorology: Remote sensing of atmospheric water vapor using the Global Positioning System, “Journal of Geophysical Research”, pp.97-100.
Zvetkova E.G.(2001), “Scientific-practical rheumatology” , Moscow, Russia. P.143.
Guzeeva V.I., Gigalas L.M., Razumovsky M.A. (2004), “Movalis in dorsopathy treatment”, Neurological and psychiatry journal n.a. Korsakov, Russia, pp.58-59.
Huskinsson E.C., Ghozlan R. and Kurthen R.(1996) “A long-term study to evaluate the safety and efficacy of melo?icam therapy in patients with rheumatoid arthritis”, Br J Rheumatol, pp.29–34.
Odinak M.M., Emelin A.U, (2004), “Movalis treatment of dorsopathy”, Neurological and psychiatry journal n.a. Korsakov, Russia, pp. 29-32.
Movalis Review Article