Although nonsteroidal anti-inflammatory drugs are effective in improving pain and disability in OA patients, to date it has been unclear to what extent these drugs could affect joint metabolism and hence joint structure. Patients with flare-up of their osteoarthritis disease process exhibit enhanced levels of markers of joint inflammation and cartilage collagen breakdown, which were markedly decreased by nimesulide but not by ibuprofen.
The effect of the addition of probenecid to oral and rectal regimes of indomethacin was studied in three groups of rheumatoid arthritic patients.
The addition of probenecid increases plasma levels of indomethacin given both orally and rectally and significantly reduces the clinical parameters of joint inflammation.
The use of probenecid with indomethacin at night may be useful in reducing morning stiffness and pain. 4 Though indomethacin plasma levels are markedly raised during concurrent probenecid therapy remarkably few side effects were observed.
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