Dolobid (diflunisal) is a nonsteroidal anti-inflammatory drug (NSAID) that works by reducing hormones that cause inflammation and pain. The drug has been shown to inhibit the progression of neuropathy and preserve quality of life in people with familial transthyretin amyloidosis (FAP).
FAP is a slow, progressive disease characterized by the buildup of abnormal deposits of proteins called amyloids in different organs and tissues. Amyloid deposits in cells of the peripheral nervous system cause peripheral neuropathy, or a loss of sensation in the arms and legs.
How Dolobid works
It reduces pain, inflammation and fever. It is derived from salicylic acid but its chemical structure is different from that of aspirin (acetylsalicylic acid).
Dolobid is part of a group of prostaglandin synthetase inhibitors or molecules that block the activity of enzymes which synthesize prostaglandins (hormone-like lipids) that cause pain and inflammation.
Dolobid in clinical trials for FAP
A Phase 2/3 study (NCT00294671) conducted from 2006 to 2012 aimed to determine if Dolobid could prevent progressive lower leg nerve damage in people with FAP.
This international, randomized, double-blind, placebo-controlled study included 130 people with FAP and clinically detectable peripheral or autonomic neuropathy. Participants were randomly assigned to receive 250 mg of Dolobid or placebo twice daily for two years.
The results showed that Dolobid slowed progression of neurological impairment and preserved participants’ quality of life.
Another study tested the safety and efficacy of long-term Dolobid use in 40 Japanese FAP patients who took 500 mg of the drug every day. The drug was well tolerated. The researchers stressed, however, that patients’ kidney function and blood cell counts must be monitored.
It is indicated for the treatment of mild to moderate pain, osteoarthritis and rheumatoid arthritis (RA). It comes as a tablet taken orally with water, milk or food every eight to 12 hours. It may take a few days to feel the full benefit of Dolobid.
Common side effects of Dolobid include nausea, vomiting, stomach pain and indigestion, diarrhea, constipation, gas, dizziness, drowsiness, headache and tiredness, rash and ringing in the ears.
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