Laboratory method predicting the maximal effective NSAID's in management of rheumatoid arthritis

ABSTRACT

Macrophages were isolated from 32 patients with acute rheumatoid arthritis [RA]. Macrophages of each patient were separately treated in-vitro with different NSAID's in the presence of immune complex [IC]. Cells inhibition was determined by measuring intracellular enzymes and number of FC receptors before and after treating the cell with NSAID's. Drug that caused maximal inhibition of FC receptors of the macrophages in-vitro was given to the patient for two weeks. Clinical assessment was done for each patient before and after treatment. The same previous procedures were followed for another 15 patients with acute RA as a control group. That group of patients were treated for two weeks by the drug that showed minimal FC receptors inhibition, It was found that the percentage of FC receptors inhibition is proportional to the clinical improvement of the disease parameters. Accordingly, this method can be used to predict the optimal effective NSAIDs for each patient before starting treatment