mrjСовременная ревматологияModern Rheumatology Journal1996-70122310-158XIMA-PRESS, LLC10.14412/1996-7012-2017-3-99-105mrj-782Research ArticleОБЗОРЫREVIEWSАцеклофенак в лечении патологии опорно-двигательного аппаратаAceclofenac in the treatment of diseases of the locomotor apparatusИголкинаЕ. В.IgolkinaE. V.

119991, Москва, ул. Трубецкая 8, стр. 2

8, Trubetskaya St., Build. 2, Moscow 119991

ЧичасоваН. В.ChichasovaN. V.

119991, Москва, ул. Трубецкая 8, стр. 2

8, Trubetskaya St., Build. 2, Moscow 119991

kafedrarheum@yandex.ruИмаметдиноваГ. Р.ImametdinovaG. R.

119991, Москва, ул. Трубецкая 8, стр. 2

8, Trubetskaya St., Build. 2, Moscow 119991

ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава РоссииРоссияI.M. Sechenov First Moscow State Medical University, Ministry of Health of RussiaRussian Federation20172609201711399105Copyright © Иголкина Е.В., Чичасова Н.В., Имаметдинова Г.Р., 20172017Иголкина Е.В., Чичасова Н.В., Имаметдинова Г.Р.Igolkina E.V., Chichasova N.V., Imametdinova G.R.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://mrj.ima-press.net/mrj/article/view/782

В статье освещены данные о механизмах действия и эффективности ацеклофенака при хронических воспалительных заболеваниях суставов и позвоночника (ревматоидном артрите, спондилоартритах) и остеоартрите. Показана сопоставимая эффективность ацеклофенака и неселективных нестероидных противовоспалительных препаратов при различных ревматических заболеваниях. На основании результатов рандомизированных контролируемых исследований и метаанализов отмечена высокая безопасность ацеклофенака в отношении желудочно-кишечного тракта, сопоставимая с таковой целекоксиба, в том числе низкий риск развития желудочно-кишечного кровотечения. Поскольку ацеклофенак не оказывает негативного влияния на суставной хрящ и отличается хорошей переносимостью, его можно применять у лиц любого возраста, в том числе длительно, что не отражается на безопасности лечения.

The paper highlights data on the mechanisms of action and efficacy of aceclofenac in chronic inflammatory diseases of the joint and spine (rheumatoid arthritis, spondyloarthritis) and osteoarthritis (OA). It shows the comparable efficacy of aceclofenac and nonselective nonsteroidal anti-inflammatory drugs in different rheumatic diseases. Randomized controlled trials and meta-analyses have revealed the high gastrointestinal safety of aceclofenac, which is comparable with that of celecoxib, including the low risk of gastrointestinal bleeding. Since aceclofenac has no negative effect on the articular cartilage and has a good tolerability, it may be given to persons of any age, including long-term use, which does not affect the safety of treatment.

нестероидные противовоспалительные препаратыацеклофенакэффективностьпереносимостьхроническая и острая больnonsteroidal anti-inflammatory drugsaceclofenacefficacytolerabilitychronic and acute painReferencesНасонов ЕЛ. Болевой синдром при патологии опорно-двигательного аппарата. Врач. 2002;(4):15-9. [Nasonov EL. Pain syndrome in the pathology of locomotor apparatus. Vrach. 2002;(4):15-9. (In Russ.)].Насонов ЕЛ. Болевой синдром при патологии опорно-двигательного аппарата. Врач. 2002;(4):15-9. [Nasonov EL. Pain syndrome in the pathology of locomotor apparatus. Vrach. 2002;(4):15-9. (In Russ.)].Barat I, Andreasen F, Damsgaard EM. The consumption of drugs by 75-year-old individuals living in their own homes. Eur J Clin Pharmacol. 2000 Sep;56(6-7):501-9.Barat I, Andreasen F, Damsgaard EM. The consumption of drugs by 75-year-old individuals living in their own homes. Eur J Clin Pharmacol. 2000 Sep;56(6-7):501-9.Kadam UT, Jordan K, Craft PR. Clinical comorbidity in patients with osteoarthritis: a case- control study of general practice consulters in England and Walls. Ann Rheum Dis. 2004 Apr;63(4):408-14.Kadam UT, Jordan K, Craft PR. Clinical comorbidity in patients with osteoarthritis: a case- control study of general practice consulters in England and Walls. Ann Rheum Dis. 2004 Apr;63(4):408-14.Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990–2013: a systematic analysis for the Global Burden of disease Stusy 2013. www.thelancet.comGlobal, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990–2013: a systematic analysis for the Global Burden of disease Stusy 2013. www.thelancet.comCaporali R, Cimmino MA, Sazzi-Puttini P, et al. Osteoarthritis in general and specialist practice in Italy: the AMICA study. Semin Arthritis Rheum. 2005 Aug;35(1 Suppl 1):31-7.Caporali R, Cimmino MA, Sazzi-Puttini P, et al. Osteoarthritis in general and specialist practice in Italy: the AMICA study. Semin Arthritis Rheum. 2005 Aug;35(1 Suppl 1):31-7.Верткин АЛ, Наумов АВ. Деформирующий остеоартроз – стратегия ведения пациентов при соматической патологии. Русский медицинский журнал. 2007;(4): 319- 24. [Vertkin AL, Naumov AV. Deforming osteoarthritis – strategy for the management of patients with somatic pathology. Russkii meditsinskii zhurnal. 2007;(4):319-24. (In Russ.)] .Верткин АЛ, Наумов АВ. Деформирующий остеоартроз – стратегия ведения пациентов при соматической патологии. Русский медицинский журнал. 2007;(4): 319- 24. [Vertkin AL, Naumov AV. Deforming osteoarthritis – strategy for the management of patients with somatic pathology. Russkii meditsinskii zhurnal. 2007;(4):319-24. (In Russ.)] .Алексеева ЛИ, Мендель ОИ, Верткин АЛ и др. Остеоартроз в практике врача- терапевта. Русский медицинский журнал. 2008;16(7):476-80. [Alekseeva LI, Mendel' OI, Vertkin AL, et al. Osteoarthritis in the practice of a general practitioner. Russkii meditsinskii zhurnal. 2008;16(7): 476-80. (In Russ.)].Алексеева ЛИ, Мендель ОИ, Верткин АЛ и др. Остеоартроз в практике врача- терапевта. Русский медицинский журнал. 2008;16(7):476-80. [Alekseeva LI, Mendel' OI, Vertkin AL, et al. Osteoarthritis in the practice of a general practitioner. Russkii meditsinskii zhurnal. 2008;16(7): 476-80. (In Russ.)].Rosemann T, Laux G, Szecsenyi J. Osteoarthritis: quality of life, comorbidities, medication and health service utilization assessed in a large sample of primary care patients. J Orthop Surg Res. 2007 Jun 30;2:12.Rosemann T, Laux G, Szecsenyi J. Osteoarthritis: quality of life, comorbidities, medication and health service utilization assessed in a large sample of primary care patients. J Orthop Surg Res. 2007 Jun 30;2:12.Van Dijk GM, Venhof C, Schellevis F, et al. Comorbidity, limitation in activities and pain in patients with osteoarthritis of the hip or knee. BMC Musculoskelet Disord. 2008 Jun 26;9:95. doi: 10.1186/1471-2474-9-95.Van Dijk GM, Venhof C, Schellevis F, et al. Comorbidity, limitation in activities and pain in patients with osteoarthritis of the hip or knee. BMC Musculoskelet Disord. 2008 Jun 26;9:95. doi: 10.1186/1471-2474-9-95.Warksman JC. Nonselective nonsteroidal anti-inflammatory drugs and cardiovascular risk: are they safe? Ann Pharmacother. 2007 Jul;41(7):1163-73. Epub 2007 Jul 3.Warksman JC. Nonselective nonsteroidal anti-inflammatory drugs and cardiovascular risk: are they safe? Ann Pharmacother. 2007 Jul;41(7):1163-73. Epub 2007 Jul 3.Савенков МП, Бродская СА, Иванов СН, Судакова НИ. Влияние нестероидных противовоспалительных средств на антигипертензивный эффект ингибиторов АПФ. Русский медицинский журнал. 2003;(19):1056-9. [Savenkov MP, Brodskaya SA, Ivanov SN, Sudakova NI. The effect of NSAIDs on the antihypertensive effect of ACE inhibitors. Russkii meditsinskii zhurnal. 2003;(19):1056-9. (In Russ.)].Савенков МП, Бродская СА, Иванов СН, Судакова НИ. Влияние нестероидных противовоспалительных средств на антигипертензивный эффект ингибиторов АПФ. Русский медицинский журнал. 2003;(19):1056-9. [Savenkov MP, Brodskaya SA, Ivanov SN, Sudakova NI. The effect of NSAIDs on the antihypertensive effect of ACE inhibitors. Russkii meditsinskii zhurnal. 2003;(19):1056-9. (In Russ.)].Grossman E, Messerli FH. Drug-induced hypertension: an unappreciated cause of hypertension. Am J Med. 2012 Jan;125(1): 14-22. doi: 10.1016/j.amjmed.2011.05.024.Grossman E, Messerli FH. Drug-induced hypertension: an unappreciated cause of hypertension. Am J Med. 2012 Jan;125(1): 14-22. doi: 10.1016/j.amjmed.2011.05.024.Scarpignato C, Lanas A, Btandizzi C, et al. Safe prescribing of non-steroidal antiinflammatory drugs in patients with osteoarthritis – an expert consensus addressing benefits as well as gastrointestinal and cardiovascular risks. BMC Med. 2015 Mar 19;13:55. doi: 10.1186/s12916-015-0285-8.Scarpignato C, Lanas A, Btandizzi C, et al. Safe prescribing of non-steroidal antiinflammatory drugs in patients with osteoarthritis – an expert consensus addressing benefits as well as gastrointestinal and cardiovascular risks. BMC Med. 2015 Mar 19;13:55. doi: 10.1186/s12916-015-0285-8.Page J, Henry D. Consumption of NSAIDs and the development of congestive heart failure in elderly patients. Arch Intern Med. 2000 Mar 27;160(6):777-84.Page J, Henry D. Consumption of NSAIDs and the development of congestive heart failure in elderly patients. Arch Intern Med. 2000 Mar 27;160(6):777-84.Heerdink ER, Leufkens HG, Herings RM, et al. NSAIDs associated with increased risk of congestive heart failure in elderly patients taking diuretics. Arch Intern Med. 1998 May 25;158(10):1108-12.Heerdink ER, Leufkens HG, Herings RM, et al. NSAIDs associated with increased risk of congestive heart failure in elderly patients taking diuretics. Arch Intern Med. 1998 May 25;158(10):1108-12.Каратеев АЕ, Насонов ЕЛ, Яхно НН и др. Рациональное применение нестероидных противовоспалительных препаратов (НПВП) в клинической практике. Москва: ИМА- ПРЕСС; 2015. 36 с. [Karateev AE, Nasonov EL, Yakhno NN, et al. Ratsional'noe primenenie nesteroidnykh protivovospalitel'nykh preparatov (NPVP) v klinicheskoi praktike [Rational use of nonsteroidal anti-inflammatory drugs (NSAIDs) in clinical practice]. Moscow: IMA-Каратеев АЕ, Насонов ЕЛ, Яхно НН и др. Рациональное применение нестероидных противовоспалительных препаратов (НПВП) в клинической практике. Москва: ИМА- ПРЕСС; 2015. 36 с. [Karateev AE, Nasonov EL, Yakhno NN, et al. Ratsional'noe primenenie nesteroidnykh protivovospalitel'nykh preparatov (NPVP) v klinicheskoi praktike [Rational use of nonsteroidal anti-inflammatory drugs (NSAIDs) in clinical practice]. Moscow: IMA-PRESS;2015. 36 p.]PRESS;2015. 36 p.]Lidburg PS, Vojnovic J, Warner TD. COX2/COX1 selectivity of aceclofenac in comparison with celecoxib and rofecoxob in the human whole blood assay. Fith world Congress of the OARSI, Barcelona, Spain, 4–6 October 2000. 2000;8(Suppl B):Th053.Lidburg PS, Vojnovic J, Warner TD. COX2/COX1 selectivity of aceclofenac in comparison with celecoxib and rofecoxob in the human whole blood assay. Fith world Congress of the OARSI, Barcelona, Spain, 4–6 October 2000. 2000;8(Suppl B):Th053.Perez Busquier M , Calero E, Rodriguez M, et al. Comparison of aceclofenac with piroxicam in the treatment osteoarthritis. Clin Rheumatol. 1997 Mar; 16(2):154-9.Perez Busquier M , Calero E, Rodriguez M, et al. Comparison of aceclofenac with piroxicam in the treatment osteoarthritis. Clin Rheumatol. 1997 Mar; 16(2):154-9.Torri G, Vignati C, Agrifoglio E, et al. Aceclofenac versus piroxicam in the management of osteoarthritis of knee: a double-blind controlled study. Curr Ther Res 1994;55(5):576-583.Torri G, Vignati C, Agrifoglio E, et al. Aceclofenac versus piroxicam in the management of osteoarthritis of knee: a double-blind controlled study. Curr Ther Res 1994;55(5):576-583.Diaz C, Rodriguez de la Serna A, Geli C, et.al. Efficacy and tolerability of aceclofenac versus diclofenacin the treatment of knee osteoarthritis: a multicenter study. Eur J Rheumatol Inflamm. 1996;16(1):17-22.Diaz C, Rodriguez de la Serna A, Geli C, et.al. Efficacy and tolerability of aceclofenac versus diclofenacin the treatment of knee osteoarthritis: a multicenter study. Eur J Rheumatol Inflamm. 1996;16(1):17-22.Ward DE, Veys EM, Bowdler JM, et al. Comparison of aceclofenac with diclofenac in the treatment of osteoarthritis. Clin Rheumatol. 1995 Nov;14(6):656-62.Ward DE, Veys EM, Bowdler JM, et al. Comparison of aceclofenac with diclofenac in the treatment of osteoarthritis. Clin Rheumatol. 1995 Nov;14(6):656-62.Kornasoff D, Frerick H, Bowdler JM, et al. Aceclofenac as a well-tolerated alternative to naproxen in the treatment of osteoarthritis. Clin Rheumatol. 1997 Jan; 16(1):32-8.Kornasoff D, Frerick H, Bowdler JM, et al. Aceclofenac as a well-tolerated alternative to naproxen in the treatment of osteoarthritis. Clin Rheumatol. 1997 Jan; 16(1):32-8.Kornasoff D,Maisenbacher J, Bowdler JM, et al. The efficacy and tolerability of aceclofenac compared to indometacin in patients with rheumatoid arthritis. Rheumatol Int. 1996;15(6):225-30.Kornasoff D,Maisenbacher J, Bowdler JM, et al. The efficacy and tolerability of aceclofenac compared to indometacin in patients with rheumatoid arthritis. Rheumatol Int. 1996;15(6):225-30.Martin-Mola E, Gijon-Banos J, Ansoleaga JJ. Aceclofenac in comparison to ketoprofen in the treatment of rheumatoid arthritis. Rheumatol Int. 1995;15(3):111-6.Martin-Mola E, Gijon-Banos J, Ansoleaga JJ. Aceclofenac in comparison to ketoprofen in the treatment of rheumatoid arthritis. Rheumatol Int. 1995;15(3):111-6.Pasero G, Marcolongo R, Serni U, et al. A multi-centre, double-blind comparative study of the efficacy of aceclofenac and diclofenac in the treatment of rheumatoid arthritis. Curr Med Res Opin. 1995;13(6):305-15.Pasero G, Marcolongo R, Serni U, et al. A multi-centre, double-blind comparative study of the efficacy of aceclofenac and diclofenac in the treatment of rheumatoid arthritis. Curr Med Res Opin. 1995;13(6):305-15.Patel PB , Patel TK. Efficacy and safety of aceclofenac in osteoarthritis: a meta-analysis of randomized controlled trials. Eur J Rheumatol. 2017 Mar;4(1):11-18. doi: 10.5152/eurjrheum.2017.160080. Epub 2017 Mar 1.Patel PB , Patel TK. Efficacy and safety of aceclofenac in osteoarthritis: a meta-analysis of randomized controlled trials. Eur J Rheumatol. 2017 Mar;4(1):11-18. doi: 10.5152/eurjrheum.2017.160080. Epub 2017 Mar 1.Lanas A, Tornero J, Zamorano JL. Assessment of gastrointestinal and cardiovascular risk in patients with osteoarthritis who require NSAIDs: the LOGICA study. Ann Rheum Dis. 2010 Aug;69(8):1453-8. doi: 10.1136/ard.2009.123166. Epub 2010 May 24.Lanas A, Tornero J, Zamorano JL. Assessment of gastrointestinal and cardiovascular risk in patients with osteoarthritis who require NSAIDs: the LOGICA study. Ann Rheum Dis. 2010 Aug;69(8):1453-8. doi: 10.1136/ard.2009.123166. Epub 2010 May 24.Chan FK. Primer: managing NSAIDinduced ulcer complications – balancing gastrointestinal and cardiovascular risks. Nat Clin Pract Gastroenterol Hepatol. 2006 Oct;3(10): 563-73.Chan FK. Primer: managing NSAIDinduced ulcer complications – balancing gastrointestinal and cardiovascular risks. Nat Clin Pract Gastroenterol Hepatol. 2006 Oct;3(10): 563-73.Peris F, Bird HA, Srni U, et al. Treatment compliance and safety of aceclofenac versus standart NSAIDs in patients with common arthritis disorders: a meta-analysis. Eur J Rheum Inflamm. 1996;16(1):37-45.Peris F, Bird HA, Srni U, et al. Treatment compliance and safety of aceclofenac versus standart NSAIDs in patients with common arthritis disorders: a meta-analysis. Eur J Rheum Inflamm. 1996;16(1):37-45.Huskisson EC, Irani M, Murray F. A large prospective open-label, multicenter SAMM study, comparing the safety of aceclofenac with diclofenac in patients with rheumatic disease. Eur J Rheumatol Inflamm. 2000;17(1):1-7.Huskisson EC, Irani M, Murray F. A large prospective open-label, multicenter SAMM study, comparing the safety of aceclofenac with diclofenac in patients with rheumatic disease. Eur J Rheumatol Inflamm. 2000;17(1):1-7.Laporte JR, Ibanez L, Vidal X, et al. Upper Gastro-Intestinal Bleeding associated with the use of NSAIDs. New vs. Older Agents. Drug Saf. 2004;27(6):411-20.Laporte JR, Ibanez L, Vidal X, et al. Upper Gastro-Intestinal Bleeding associated with the use of NSAIDs. New vs. Older Agents. Drug Saf. 2004;27(6):411-20.Llorente MJ. Specific types of nonsteroidal anti-inflammatory drugs and relative risk of upper gastrointestinal bleeding [abstract]. Br J Rheumatol. 1998; 37 Suppl.1:115Llorente MJ. Specific types of nonsteroidal anti-inflammatory drugs and relative risk of upper gastrointestinal bleeding [abstract]. Br J Rheumatol. 1998; 37 Suppl.1:115Masso Gonzalez EL, Patrignani P, Tacconelli S, Garcia Rodriguez LA. Variability among nonsteroidal antiinflammatory drugs in risk of upper gastrointestinal bleeding. Arthritis Rheum 2010;62(6):1592-601.Masso Gonzalez EL, Patrignani P, Tacconelli S, Garcia Rodriguez LA. Variability among nonsteroidal antiinflammatory drugs in risk of upper gastrointestinal bleeding. Arthritis Rheum 2010;62(6):1592-601.Castellsague J, Riera-Guardia N, Calingaert B, et al. Safety of Non-Steroidal Anti- Inflammatory Drugs (SOS) Project. Individual NSAIDs and upper gastrointestinal complications: a systematic review and meta-analysis of observational studies (the SOS project). Drug Saf 2012;35(12):1127-46.Castellsague J, Riera-Guardia N, Calingaert B, et al. Safety of Non-Steroidal Anti- Inflammatory Drugs (SOS) Project. Individual NSAIDs and upper gastrointestinal complications: a systematic review and meta-analysis of observational studies (the SOS project). Drug Saf 2012;35(12):1127-46.Yanagawa A, Endo T, Kusakari K, et al. Endocopic evaluation of aceclofenac-induced gastrointestinal mucosal damage: a doubleblind comparison with sodium diclofenac and placebo. Jpn J Rheum. 1998;8:249-59.Yanagawa A, Endo T, Kusakari K, et al. Endocopic evaluation of aceclofenac-induced gastrointestinal mucosal damage: a doubleblind comparison with sodium diclofenac and placebo. Jpn J Rheum. 1998;8:249-59.Парфенов ВА, Герасимова ОН. Клинический опыт амбулаторного ведения пациентов с болью в спине. Consilium Medicum. Неврология и ревматология. 2013;Прил. 1:5-7. [Parfenov VA, Gerasimova ON. Clinical experience the outpatient management of patients with back pain. Consilium Medicum. Neurology and rheumatology. 2013; Suppl 1:5-7. (In Russ.)].Парфенов ВА, Герасимова ОН. Клинический опыт амбулаторного ведения пациентов с болью в спине. Consilium Medicum. Неврология и ревматология. 2013;Прил. 1:5-7. [Parfenov VA, Gerasimova ON. Clinical experience the outpatient management of patients with back pain. Consilium Medicum. Neurology and rheumatology. 2013; Suppl 1:5-7. (In Russ.)].Schattenkirchner M, Milachowsk KA. A double-blind, multi-center clinical trial compuring the efficacy and tolerability of aceclofenac with diclofenac – resinate in patients with acute low back pain. Clin Rheumatol. 2003 May;22(2):127-35.Schattenkirchner M, Milachowsk KA. A double-blind, multi-center clinical trial compuring the efficacy and tolerability of aceclofenac with diclofenac – resinate in patients with acute low back pain. Clin Rheumatol. 2003 May;22(2):127-35.Martel-Pelletier J, Cloutier JM, Pelletier JP. Effect of aceclofenac and diclofenac on synovial inflammatory factors in human osteoarthritis. Clin. Drug Invest. 1997;14(3):226-32.Martel-Pelletier J, Cloutier JM, Pelletier JP. Effect of aceclofenac and diclofenac on synovial inflammatory factors in human osteoarthritis. Clin. Drug Invest. 1997;14(3):226-32.Henrotin Y, de Laval X, Mathy-Hartet M, et.al. In vitro effects of aceclofenac and its metabolites on the production by chondrocytes of inflammatory mediators. Inflamm Res. 2001 Aug;50(8):391-9.Henrotin Y, de Laval X, Mathy-Hartet M, et.al. In vitro effects of aceclofenac and its metabolites on the production by chondrocytes of inflammatory mediators. Inflamm Res. 2001 Aug;50(8):391-9.Gonsalez E, de la Cruz C, de Nicola's R, et al. Long-term effect of nonsteroidal antiinflammatory drugs on the production of cytokines and other inflammatory mediators by blood cells of patients with osteoarthritis. Agents Actions. 1994 May;41(3-4):171-8.Gonsalez E, de la Cruz C, de Nicola's R, et al. Long-term effect of nonsteroidal antiinflammatory drugs on the production of cytokines and other inflammatory mediators by blood cells of patients with osteoarthritis. Agents Actions. 1994 May;41(3-4):171-8.Blanco FJ, Maneiro E, de Toro FJ, et al. Effect of NSAIDs on synthesis of IL-1 receptor antagonist (IL-Ra) by human articular chondrocytes [abstract]. Osteoarthritis Cartilage. 2000;8 Suppl.:S27Blanco FJ, Maneiro E, de Toro FJ, et al. Effect of NSAIDs on synthesis of IL-1 receptor antagonist (IL-Ra) by human articular chondrocytes [abstract]. Osteoarthritis Cartilage. 2000;8 Suppl.:S27Akimoto H, Yamazaki R, Hashimoto S, et al. 4-Hydroxy aceclofenac suppressed the interleukin-1-induced production of promatrix metalloproteases and release of sulfated- glycosaminoglycans from rabbit articular chondrocytes. Eur J Pharmacol. 2000 Aug 11;401(3):429-36.Akimoto H, Yamazaki R, Hashimoto S, et al. 4-Hydroxy aceclofenac suppressed the interleukin-1-induced production of promatrix metalloproteases and release of sulfated- glycosaminoglycans from rabbit articular chondrocytes. Eur J Pharmacol. 2000 Aug 11;401(3):429-36.Yamazaki R, Kawai S, Mizushima Y, et al. A mayor metabolite of aceclofenac, 4-hydroxy aceclofenac, suppressed the production of interstitial pro-collafenase|proMMP-1 and pro- stromelysin-1|proMMP-3 human rheumatoid synovial cells. Inflamm Res. 2000 Mar;49(3):133-8.Yamazaki R, Kawai S, Mizushima Y, et al. A mayor metabolite of aceclofenac, 4-hydroxy aceclofenac, suppressed the production of interstitial pro-collafenase|proMMP-1 and pro- stromelysin-1|proMMP-3 human rheumatoid synovial cells. Inflamm Res. 2000 Mar;49(3):133-8.

The authors declare that there are no conflicts of interest present.