Assessment of salsalate, a nonacetylated salicylate, in the treatment of patients with arthritis.

This study evaluated physicians' use of the occurrence of tinnitus as a tool to establish the optimal dosage of salsalate, a nonacetylated salicylate, in patients with arthritis treated in routine clinical practice. The use of printed educational materials to improve compliance was also studied prospectively. A total of 782 patients were enrolled in this 3-week study by 95 general practitioners in an office setting. Of the 771 assessable patients, 90.0% had osteoarthritis, 9.7% had rheumatoid arthritis, and 0.3% had both types of arthritis. Most patients experienced improvement of symptoms after 3 weeks of treatment. There were no differences in the rates of improvement at the first and third weeks of treatment between patients with osteoarthritis and patients with rheumatoid arthritis. In addition, duration of arthritis had no effect on rates of improvement. Rates of patient satisfaction tended to increase over the study period. Rates of patient satisfaction did not differ significantly at the first and third weeks between patients who did not receive printed educational materials and whose who did not. Treatment was discontinued in 234 patients (30.4%) because of side effects. The most frequent reasons for discontinuation were gastrointestinal symptoms (n = 102; 13.2%) and tinnitus (n = 52; 6.7%). The clinical effectiveness and safety of salsalate were confirmed in patients with arthritis in routine clinical practice settings.

Patient compliance with tenoxicam in family practice.

This study evaluated factors that may influence patient compliance and also confirmed tolerability and efficacy of tenoxicam in routine clinical practice. Compliance in 1809 patients was evaluated over a 4-week period by physician pill-counts, patient assessment cards, and, for a subpopulation, by electronically monitored pill vials. In addition, physicians documented patient improvement and side effects after 2 weeks and after 4 weeks of therapy; patients reported satisfaction with therapy and side effects on a weekly basis. A total of 399 physicians provided data on 1809 patients, of whom 84.3% had osteoarthritis, 12.6% had rheumatoid arthritis, and 3.2% had ankylosing spondylitis. The typical patient was a woman (64.9%), white (91.2%), in her 50s (mean age, 57.9 years), with a duration of osteoarthritis of at least 1 year (72.3%). High and similar compliance rates were achieved by patients regardless of age, gender, or diagnostic category. Patient and disease characteristics were similar between compliant and noncompliant patients. Most patients (81.1%) experienced improvement of symptoms after 4 weeks of treatment. A low incidence of side effects (12.6%) was reported, with no significant differences observed among patients with respect to age, gender, or diagnostic category. Product characteristics, such as tolerability, efficacy, and dosing regimen, are more significant factors of compliance than patient or disease characteristics. Tenoxicam's tolerability and clinical effectiveness were confirmed in patients with arthritis in routine clinical practice settings.

Peroxidation of liver lipids in the pathogenesis of the ethanol-induced fatty liver.

Administration of an acutely intoxicating dose of ethanol produced significant increases in the concentration of liver triglyceride and enhanced the peroxidation of liver lipids in rats. Adipose triglyceride and lipid peroxide concentrations were unaltered. Coenzyme Q(4), an effective antioxidant, significantly inhibited accumulation of liver triglyceride following ethanol intoxication and prevented the peroxidation of liver lipids. These results, which demonstrate the selective ability of ethanol to induce peroxidation of liver lipids, together with the effectiveness of antioxidants, support the previously proposed hypothesis that peroxidation of liver lipids following ethanol intoxication is a factor in the pathogenesis of ethanol-induced liver injury.