Correlation of serologic indicators of inflammation with effectiveness of nonsteroidal antiinflammatory drug therapy in rheumatoid arthritis

Abstract

Forty-seven patients with rheumatoid arthritis (mean duration 5.7 years) who were receiving neither disease-modifying drugs nor corticosteroids were enrolled in a 12-week, multicenter study of the relationship between clinical and serologic measures of disease activity in patients taking nonsteroidal antiinflammatory drugs. After a 2-week drug washout period, patients received flurbiprofen (200 mg/day) or sustained-release ibuprofen (2,400 mg/day) for a 10-week trial. Clinical response was assessed biweekly using standard clinical parameters, including 50-foot walk time, tender joint score, duration of morning stitfness, and global assessment of disease activity and pain (by both the patient and the physician). Patients were classified as responders if there was 230% improvement in at least 3 of the 4 clinical measures of disease activity. Thirty patients completed at least 8 weeks of therapy; there were 12 responders and 18 nonresponders. Of the laboratory From the Harold C.

Factors associated with toxicity, final dose, and efficacy of methotrexate in patients with rheumatoid arthritis

“…A study by Cush et al showed a positive effect of NSAIDs on disease activity. 31 In contrast with others we found a relation between renal function and good response. The response was better in patients with a lower creatinine clearance.…”

Clinical response to non‐steroidal anti‐inflammatory drugs in urate‐ crystal induced inflammation: a simultaneous study of intersubject and intrasubject variability.

“…Furthermore, the fact that the erythematous reaction was only partially inhibited by ibuprofen (20%) suggests the vascular changes induced by urate crystals are only partly due to prostaglandins via activation of cyclo-oxygenase. Our data provide indirect evidence suggesting that differences in biochemical determinants of inflammation between subjects may explain variability in response to NSAIDs [11].…”

“…Failure to obtain relief with one drug usually leads to a rotation through a series of drugs until a satisfactory response is obtained [5]. Significant between-subject variation has been noted in several studies [4,5,[6][7][8][9][10][11]. The basis for this is unknown but it has been suggested that this variability could be either pharmacokinetic and/or pharmacodynamic in origin.…”

Increased levels of circulating intercellular adhesion molecule 1 in the sera of patients with rheumatoid arthritis

“…These correlations, however, were less striking than those between more traditional measures of disease activity (14). These findings tend to discourage the clinical application of cICAM-1 determinations as a gauge of clinical activity in RA.…”

“…Correlation of cICAM-1 with disease activity. Serum samples were collected from 25 RA patients who participated in a 12-week NSAID protocol (14,15). Serum cICAM-1 levels were compared with a variety of clinical variables and measures of disease activity.…”