Clinical response to etodolac in the management of pain.

Etodolac is a new nonsteroidal anti-inflammatory drug (NSAID). Published and unpublished data on etodolac in pain management are reviewed to assess the analgesic effectiveness of this drug. Data are presented from four representative studies that showed the analgesic activity of etodolac in postsurgical pain models. These results suggest that the drug would have analgesic utility in other painful conditions such as gout and musculoskeletal disorders. The efficacy of etodolac in such conditions is confirmed by the results from eight controlled clinical studies in patients with gouty arthritis, tendinitis and bursitis, and acute sports injuries. Etodolac 200 or 300 mg twice a day (b.i.d.) or 200 mg three times a day (t.i.d.) was compared with naproxen 500 mg b.i.d. and diclofenac 50 mg b.i.d. or 50 mg t.i.d. All three NSAIDs provided analgesia, and etodolac was comparable in efficacy to the comparators. The data presented in this review suggest a future role for etodolac as an analgesic as well as an anti-inflammatory agent.

Oral chrysotherapy in rheumatoid arthritis: minimum effective dose.

We studied the dose-response to a new oral gold compound in 28 patients with definite rheumatoid arthritis, divided in 4 groups of 7 patients, each treated with different doses of auranofin for 3 months. Clinical and laboratory parameters were recorded weekly, and blood gold levels (BGL) measured by atomic absorption spectroscopy. Six and 9 mg daily doses of auranofin were most effective based on clinical and laboratory results. Correlation studies between BGL and percent decrease of humoral measurements, within the 3 months were statistically were statistically significant. Mean BGL, associated with clinical improvement, reached 0.73 microgram/ml, and was accompanied by a 17.6% decrease from initial value of IgG, 17.1% of alpha 2-globulin, 48.9% of RF titer and 25.9% of ESR.

Auranofin. New oral gold compound for treatment of rheumatoid arthritis.

Eight patients with rheumatoid arthritis were treated with SK & F D-39162 (auranofin), a new oral gold compound which was effective in suppressing adjuvant-induced arthritis in rats. Clinical and humoral parameters were studied during a 3-month period of drug administration followed by a 3-month period under placebo. The drug was absorbed, well tolerated, and its action was manifested by a drop in the mean IgG blood levels in the third week of treatment accompanied by clinical improvement after 5 weeks of oral gold intake. Together with IgG changes, an increase of the albumin ratio was observed, as well as a decrease of alpha2-globulin and rheumatoid factor titres. From a total number of 60 swollen joints found initially in the 8 patients only 17 were swollen at week 12 and 9 at week 15. Although the number of patients treated was too small to allow definite conclusions, a follow-up study under placebo of clinical and laboratory changes in the same patients during another 3-month period showed that IgG serum levels rapidly reverted preceding a flare up of disease activity after withdrawal of the drug. This confirmed a direct role in cause-effect relation played by the new oral gold compound.