A Clinical Trial of a New Anti-Inflammatory/Analgesic Compound in Rheumatoid Arthritis – GP 45 840

1973 ◽  
Vol 1 (7) ◽  
pp. 591-599 ◽  
Author(s):  
S A Ghazi ◽  
P D Fowler
Keyword(s):  
Rheumatoid Arthritis ◽  
White Cell Count ◽  
Liver Function Tests ◽  
Patient Treatment ◽  
Double Blind ◽  
Drug Intolerance ◽  
Acid Sodium Salt ◽  
Anti Inflammatory ◽  
Inflammatory Changes ◽  
Symptoms And Signs

GP 45 840, N-( 2-6-dichlorophenyl)-o-aminophenylacetic acid, sodium salt, has been shown pharmacologically to have good analgesic and anti-inflammatory properties. GP 45 840 in progressively increasing dosage from 50 to 150 mg per day was compared with a placebo in a double-blind cross-over trial in thirteen patients with rheumatoid arthritis, GP 45 840 and placebo each being given for one week. GP 45 840 produced no more intolerance than did placebo therapy. The rather high mean white cell count of the placebo period was lower during treatment with GP 45 840 but n ever below the normal range. GP 45 840 had no effect on weight, erythrocyte sedimentation rate, renal and liver function tests or other haematological tests. The following features were assessed twice weekly; pain, morning stiffness, grip strength, swelling, tenderness, and range of certain joints, requirements of supplementary analgesics and drug intolerance. An improvement, independent of the effects of GP 45 840 was observed in several of the features assessed, including decrease in potentially reversible joint swelling, but GP 45 840 resulted in a further significant reduction in pain and requirements of supplementary analgesics. An anti-inflammatory effect on early synovitis of the p.i.p joints was demonstrated though not conclusively proved. The trial procedures were sufficiently sensitive to demonstrate significant improvement in many symptoms and signs of rheumotoid arthritis due to overall in-patient treatment during a two week period. A new method of analysis of p.i.p size was used. Joints were graded clinically into four categories of joint swelling. Although overall measurements showed no significant change, a significant decrease in joint size was demonstrable in joints graded as having ‘definite’ synovial inflammatory changes.

A Double Blind Cross over Study of Ibuprofen, Metiazinic Acid, Aspirin and a Placebo in Rheumatoid Arthritis

1972 ◽  
Vol 1 (1) ◽  
pp. 18-21 ◽  
Author(s):  
T Hadidi ◽  
D K Asar ◽  
A Esmat
Keyword(s):  
Rheumatoid Arthritis ◽  
Side Effects ◽  
Knee Score ◽  
Subjective Improvement ◽  
Double Blind ◽  
Erythrocyte Sedimentation ◽  
Before And After ◽  
Anti Inflammatory ◽  
Articular Index ◽  
Inflammatory Action

In a double-blind cross-over study the analgesic and anti-inflammatory action of ibuprofen 1600 mg/day in cases of rheumatoid arthritis has been compared with aspirin 4 g/day, metiazinic acid 1 .5 g/day and a placebo, lactose. Each compound was administered in identical capsules and in a totally randomised order to all patients studied. Assessment of the articular index, grip strength, knee score, erythrocyte sedimentation rate and subjective improvement was made before and after one week's treatment with each drug. In the doses used in this trial, the analgesic and anti-inflammatory activity of metiazinic acid in rheumatoid arthritis, was found to be approximately equipotent to that of aspirin, while ibuprofen seemed to be slightly more potent and to cause fewer side-effects.

Diftalone: A New Non-Steroidal Anti-Inflammatory Agent: Comparative Study with Phenylbutazone in the Treatment of Rheumatoid Arthritis

1977 ◽  
Vol 5 (1) ◽  
pp. 18-25 ◽  
Author(s):  
F Chalem ◽  
P Farias ◽  
H Lizarazo ◽  
P Peña
Keyword(s):  
Rheumatoid Arthritis ◽  
Side Effects ◽  
Comparative Study ◽  
Clinical Improvement ◽  
Laboratory Tests ◽  
Double Blind Study ◽  
Double Blind ◽  
Treatment Groups ◽  
Inflammatory Agent ◽  
Anti Inflammatory

A double-blind study was carried out to compare the effectiveness and tolerability of diftalone and phenylbutazone in thirty patients with classical or definite rheumatoid arthritis, randomly distributed between the two treatment groups. Both drugs were administered according to a progressively decreasing daily dosage schedule: 1,000 mg during the 1st week; 750 mg the 2nd week and 500 mg from the 3rd week on for diftalone; 400 mg, 300 mg, and 200 mg daily for the 1st, 2nd and from the 3rd week on respectively for phenylbutazone. The study lasted twelve weeks. The clinical controls and laboratory tests were performed weekly up to the 8th week, while the final evaluation was made at the end of the 3rd month. Twelve patients in the group receiving diftalone and fourteen in the phenylbutazone group completed the trial. Clinical improvement was observed in both groups. Effectiveness was somewhat more evident in the diftalone group. Tolerability was acceptable for both drugs, although the diftalone patients showed less frequent and intense side-effects than those treated with phyenylbutazone. No significant differences were found as regards the laboratory parameters, except a significant fall of the E.S.R. (p < 0·05) in the diftalone group. Diftalone seems to be an effective and safe anti-inflammatory agent in the treatment of rheumatoid arthritis.

A Controlled Clinical Trial of a New Anti-Inflammatory Drug, Diftalone, in Rheumatoid Arthritis

1974 ◽  
Vol 2 (5) ◽  
pp. 338-346 ◽  
Author(s):  
Valentin Stroescu ◽  
Carmen Georgescu ◽  
Radu Voiosu
Keyword(s):  
Rheumatoid Arthritis ◽  
Clinical Trial ◽  
Randomized Trial ◽  
Term Treatment ◽  
Controlled Clinical Trial ◽  
Double Blind ◽  
Inflammatory Drug ◽  
Long Term Treatment ◽  
Anti Inflammatory

In a double-blind, randomized trial on thirty-two patients affected by classical or definite rheumatoid arthritis, we have tried the effectiveness and safety of 500 mg/day oral diftalone versus 75 mg/day oral indomethacin for a period of six to twelve months treatment. Diftalone proved to be an effective and well tolerated anti-inflammatory drug in long-term treatment of rheumatoid arthritis. Its activity and safety is at least comparable to that achieved by the use of indomethacin.

Mefenamic Acid Compared with Ibuprofen in the Treatment of Rheumatoid Arthritis

1977 ◽  
Vol 5 (3) ◽  
pp. 161-163 ◽  
Author(s):  
R D G Leslie
Keyword(s):  
Rheumatoid Arthritis ◽  
Side Effects ◽  
Mefenamic Acid ◽  
Double Blind ◽  
Patient Study ◽  
Anti Inflammatory ◽  
Inflammatory Effect

A randomized double-blind within-patient study of mefenamic acid compared with ibuprofen was performed on forty patients with rheumatoid arthritis. It was concluded that mefenamic acid and ibuprofen had an analgesic and anti-inflammatory effect which was not significantly different in the dosages employed. Apart from six complaints of drowsiness on ibuprofen with two complaints on mefenamic acid, the side-effects were similar.

scholarly journals AB1080 OPTICAL SPECTRAL TRANSMISSION IMAGING SCORES DECREASE AFTER ONE MONTH OF BIOLOGICAL THERAPY, ESPECIALLY IN RHEUMATOID ARTHRITIS PATIENTS WHO RESPOND TO THERAPY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1829.2-1829
Author(s):  
A. Blanken ◽  
C. J. Van der Laken ◽  
M. Nurmohamed
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Response To Therapy ◽  
Tender Joint Count ◽  
Imaging Method ◽  
Spectral Transmission ◽  
Transmission Imaging ◽  
Before And After ◽  
Anti Inflammatory ◽  
Inflammatory Changes

Background:Optical spectral transmission imaging (OST) is a new imaging method that measures inflammation in the hands of rheumatoid arthritis (RA) patients. OST might be used to assess disease activity instead of disease activity score 28 (DAS28) or ultrasonography (US). The advantage of OST is that it is fast and not operator dependent. Up to now OST has only been investigated cross-sectionally and it is unknown if and to what extent OST can detect inflammatory changes due to anti-inflammatory treatment for RA.Objectives:To compare OST measurements before and after 1 month of biological treatment for RA and to compare these OST changes with changes on US and disease activity.Methods:The HandScan device from Hemics, the Netherlands, was used to measure OST scores for 13 RA patients before and after 1 month of anti-inflammatory therapy. Treatment included tumor necrosis factor inhibitor (n=10), tocilizumab (n=2) and tofacitinib (n=1). OST scores range from 0-66 (one score for both hands) and are based on bilateral wrist, MCP and PIP joints. US was performed in the same joints as OST and semi-quantitatively scored on a scale of 0-3 for grey-scale (GS) synovitis and power Doppler (PD) signal. Joint scores of GS synovitis or PD were summed, resulting is a total GS synovitis score and a total PD score, both also ranging from 0-66. Furthermore, tender joint count 28 (TJC28), swollen joint count 28 (SJC28), DAS28, C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were determined. Response to therapy was defined as achieving the minimal clinically interesting improvement of DAS28 (DAS28 difference after 1 month > -1) as proposed by Ward et al. [1]Results:Baseline OST was 17.73 ± 6.10 and this significantly decreased to 16.01 ± 6.68 (difference -1.71, 95%CI 0.05-3.38, p=0.045) after 1 month of therapy. This decrease was only present in patients who responded to therapy (n=8; OST decreased from 17.24 ± 5.98 to 14.26 ± 5.65, p=0.01) and not in non-responders (n=5; OST increased from 18.52 ± 6.90 to 18.83 ± 7.87, p=0.03).In the total group, also DAS28 (difference -1.59, 95%CI 0.74-2.45, p=0.002), SJC28 (difference 4.62, 95%CI 1.50-7.73, p=0.007), ESR (Wilcoxon Rank p=0.008) and CRP (Wilcoxon Rank p=0.03) significantly decreased after 1 month of therapy, but TJC28 did not (difference 2.62, 95%CI -2.7-7.91, p=0.30).OST change after 1 month of therapy significantly correlated with TCJ28 change (table 1). For GS synovitis the correlation coefficient nearly reached statistical significance. Changes in all other disease activity parameters were not correlated with OST change.Table 1.Correlation of change in OST measurement with change in disease activity after 1 months of anti-inflammatory therapySpearman rp-valueTotal GS synovitis0.540.06Total PD0.220.47DAS280.350.25SJC280.290.33TJC280.630.02ESR-0.420.15CRP-0.230.45Conclusion:OST scores significantly decreased after 1 month of anti-inflammatory therapy and only in the RA group that responded well to this therapy. This indicates that OST is capable of detecting therapy induced inflammatory changes in the hands of RA patients. Larger studies are needed to further assess the monitoring value of OST for therapy efficacy in RA patients.References:[1]Ward et al. 2015 Clinically important changes in individual and composite measures of rheumatoid arthritis activity: thresholds applicable in clinical trials. Ann Rheum Dis 74(9): p. 1691-6.Disclosure of Interests:Annelies Blanken: None declared, C.J. van der Laken: None declared, Michael Nurmohamed Grant/research support from: Not related to this research, Consultant of: Not related to this research, Speakers bureau: Not related to this research

Long-Term Controlled Clinical Trial of a New Anti-Inflammatory Drug, Diftalone, in Rheumatoid Arthritis

1976 ◽  
Vol 4 (1) ◽  
pp. 23-33 ◽  
Author(s):  
V Stroescu ◽  
C Georgescu ◽  
R Voiosu
Keyword(s):  
Rheumatoid Arthritis ◽  
Comparative Trial ◽  
Lower Number ◽  
Controlled Clinical Trial ◽  
Clinical Parameters ◽  
Double Blind ◽  
Erythrocyte Sedimentation ◽  
Number Of Patients ◽  
Anti Inflammatory

A long-term ( two years) double-blind, comparative trial of diftalone ( Aladione®) 500 mg versus indomethacin 75 mg per day, in rheumatoid arthritis ( thirty-two patients), has shown a similar effectiveness for both anti-inflammatory agents on various clinical parameters of disease activity, some better results being obtained for diftalone as regards the capacity of reducing erythrocyte sedimentation rate. The tolerability of diftalone proved to be somewhat superior, as is shown by the lower number of patients complaining of side-effects or being dropped out for intolerance, and by the lower frequency of central nervous system disturbances.

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