Search

Out of thirty-six patients with mild to moderate hypertension twenty-six patients completed a double-blind comparison of slow-release frusemide at two dose levels, and placebo. The two groups differed in their age pattern, baseline level of blood pressure and response to a low-salt diet during the wash-out/run-in period. Despite the lack of comparability of the two groups, firm clinical inferences could be drawn from the study. Seven of the eighteen placebo patients had to be withdrawn from further participation because of deterioration in their hypertension: in contrast, fifteen of the eighteen frusemide patients showed an anti-hypertensive response and none was withdrawn because of lack of effect. Twice-daily administration of the slow-release formulation, however, produced an unacceptable level of such side-effects as nocturia, nausea and vomiting. Once-daily administration of the preparation is therefore preferred.

Abstract: The analgesic efficacy of 100 and 200 mg isoxepac was compared with that of 50 mg indomethacin in a double‐blind, single‐dose, between‐patient (parallel) study with placebo control. Oral doses were administered to 120 patients whose postoperative plan justified administration of analgesics on the morning of the day following knee surgery for meniscectomy. No appreciable differences emerged between 100 mg isoxepac and placebo, though 50 mg indomethacin and 200 mg isoxepac gave better analgesia than either 100 mg isoxepac or placebo. Peak and duration of pain relief was of the same order with 50 mg indomethacin, and 200 mg isoxepac would appear to be the minimal effective dose in the clinical setting of postoperative pain following knee meniscectomy. The incidence of side effects on all three active treatments was remarkedly low.

Abstract: Thirty‐eight ambulatory patients with congestive cardiac failure took part in a double‐blind clinical trial of 50 mg hydrochlorothiazide orally daily and slow‐release formulation of 60 mg furosemide orally daily. Following a one‐week period of placebo administration, patients were randomly allocated to the treatment which they continued for six weeks. Other diuretic drugs were discontinued at entry, but antihypertensive drugs and digoxin were continued during the study at constant dosage. A controlled sodium diet was prescribed. Clinical observations and biochemical and hematologic measurements were made before, during, and at the end of the study. There was an improvement in the clinical condition of patients in both treatment groups, but no significant difference between treatments (with or without digitalis) was detected. Both treatments were clinically well tolerated; however, the tendency of hypokalemia was more pronounced in the hydrochlorothiazide group. This could be hazardous in patients who receive a concomitant cardiac glycoside, especially when no clear‐cut benefit of concomitant digitalis therapy is demonstrated.

Atenolol 100 mg and penbutolol 40 mg given once a day were both effective in controlling moderate hypertension, as judged by a randomised controlled, double-blind trial in 45 patients treated for six weeks. Both drugs significantly reduced the resting supine and erect blood pressures. No serious adverse effects could be attributed to either drug. Bradycardia occurred more frequently with atenolol than with penbutolol. Penbutolol, which possesses intrinsic sympathomimetic activity, may be useful in the treatment of patients in whom some other beta-blocker has failed to bring about adequate control of the blood pressure, despite marked bradycardia.

We recruited 71 previously untreated patients with metastatic prostatic carcinoma to 2 separate consecutive prospective phase 2 studies done by the same group of investigators according to the same protocols in which only the treatment regimens differed. Of the patients 58 were treated with the luteinizing hormone-releasing hormone analogue buserelin alone (0.4mg. 3 times daily intranasally) and 13 were treated with buserelin combined with cyproterone acetate, a potent antiandrogen (50mg. 3 times daily orally). The objective of the study was to investigate the efficacy, safety and tolerability of the medication used during at least 12 months by studying adequate endocrine parameters, the rate and duration of response, as well as the rate of progression and possible side effects. All endocrine parameters were studied in 1 laboratory. Modified response criteria of the National Prostatic Cancer Project were used.

Fifty-one women with pelvic endometriosis were treated with the gonadotropin-releasing hormone agonist (GnRHa) Buserelin (Hoechst Holland N.V., Amsterdam, The Netherlands) 300 μg three times a day intranasally for 6 months. Forty-nine women completed treatment; 42 were available for 6 months of follow-up following treatment. Symptoms showed prompt and significant improvement. Follow-up after treatment revealed persistent relief from dysmenorrhea and dyspareunia in, respectively, 58.6% and 88.2% of the women, whereas pelvic pain returned to pretreatment scores. Serum estradiol (E2) was suppressed to predominantly early follicular phase concentrations. Laparoscopy at the end of therapy showed significant reduction of scores for implants only. There was no relation between the degree of E2suppression during therapy and the improvement of symptoms or the reduction of endometriosis. Statistical analysis in 22 infertile patients, of whom 7 conceived during follow-up, revealed no differences in E2levels during therapy, improvement of symptoms, or reduction of endometriosis. Buserelin appears to be safe, well tolerated, and effective in the management of endometriosis and associated complaints.

Antihypertensive therapy was stopped in twenty-one patients with moderate hypertension. Almost all of them had been on combination therapy, usually propranolol or metoprolol with chlorthalidone, for more than a year. After a placebo ‘wash-out’ period of 4 weeks patients were randomly allocated in a controlled trial to a fixed daily dose of either 100 mg atenolol or 40 mg penbutolol for 6 weeks. Single-agent therapy at these doses successfully controlled the blood pressure in nineteen of the twenty-one patients, including six previously inadequately controlled on a combination. Although no conclusions can be drawn about the long-term benefits, in the patient population under study either penbutolol or atenolol given at a standard dose should provide good initial blood pressure control in most patients with mild to moderate hypertension.

To compare the natriuretic and diuretic effects of a slow-release and a standard formulation of furosemide, 18 elderly patients with stable congestive heart failure were hospitalized and treated with one of these formulations in a double blind randomized trial. Patients received placebo on the first 2 days, furosemide on the third day and placebo again on the last 2 days of the study. In patients receiving the standard formulation mean urine output was increased only on the day of active treatment. However, in patients who had received the slow-release preparation, increased urine excretion was seen both on the day of active treatment and on the subsequent day. The total diuresis (0–48 h) in the 2 groups was equal, but a peak diuresis (0–6 h) was seen only in patients on the standard formulation of furosemide. Sodium excretion followed the pattern of urine excretion. Furosemide in a slow-release formulation offers advantages in maintenance therapy in congestive heart failure, especially in elderly patients.