Clinical experience of clozapine-induced neutropenia in the UK. Laboratory investigation using liquid culture systems and immunofluorocytometry.

An incidence of drug-induced neutropenia of 2.5% has been found in the first 1000 patients to be treated with clozapine in the UK. The majority of affected patients experienced mild neutropenia (n = 22) with only 3 patients developing agranulocytosis. Data collected from these 25 patients suggest that the mechanism of neutropenia may be multifactorial. Laboratory investigation using liquid culture systems and immunofluorocytometry has identified clozapine and its major metabolite N-desmethyl clozapine as exhibiting toxic effects against myeloid maturation and myeloid mitotic compartments, respectively. Increased susceptibility to the toxic effects of clozapine was shown in 1 patient who had previously developed clozapine-associated neutropenia. No clinical or laboratory evidence of drug-induced antineutrophil or antimyeloid precursor antibodies was found.

An open multiple dose study of Optrex Eye Lotion in eye irritation due to hayfever.

Twenty-four patients consulting their general practitioner with eye irritation due to hayfever entered a seven-day open, multiple dose study of a newly formulated Optrex Eye Lotion. Patients self-administered Optrex by irrigation into their left eye three times daily for seven days, with an option to use the same preparation in their right eye if they thought this to be of benefit. Assessment was by means of daily diary cards completed by the patient each evening for the seven-day period. Following the first instillation, the treated eye felt significantly better at 20 seconds and at four minutes when compared with the untreated eye. Differences between the eyes for degree of redness, comfort and clearness of vision were not significant, but 15 patients (63 per cent) optionally used Optrex in their right eye. Seventeen patients (71 per cent) reported that they derived overall benefit from the use of Optrex Eye Lotion during the study period. Two patients reported side effects during the study but, in each case, the investigator did not consider the event to be therapy related. One patient withdrew on Day 7 of the trial due to worsening of their allergic conjunctivitis. It can be concluded that some subjective benefit was gained by the majority of patients in that a considerable number of them chose to treat both eyes for the duration of the study.

Night pain and morning stiffness in osteoarthritis: a crossover study of flurbiprofen and diclofenac sodium.

Forty patients took part in an observer-blind multiple dose crossover study to compare the efficacy and tolerability of 300 mg flurbiprofen (100 mg twice a day orally and 100 mg suppository at night) with 75 mg diclofenac sodium (25 mg twice daily orally and 25 mg suppository at night) in the relief of night pain and morning stiffness in patients with osteoarthritis. Equal numbers of patients were randomized to receive one of the treatments for the first 7-day treatment period and then the other treatment for the second 7-day treatment period. There were significant differences in favour of flurbiprofen for the reduction in night pain, improvement in quality of sleep and patients' assessment of overall improvement on treatment. Two patients withdrew from the study due to side-effects experienced whilst taking diclofenac sodium during the first treatment period. Eight patients in all reported a total of 18 side-effects during this study. Six patients reported 12 side-effects whilst taking diclofenac sodium compared with three patients who reported six side-effects whilst taking flurbiprofen. This study confirms the good efficacy and tolerability of flurbiprofen in the symptomatic relief of osteoarthritis.

Syrup formulations for post-tonsillectomy analgesia: a double-blind study comparing ibuprofen, aspirin and placebo.

Post-tonsillectomy analgesia from ibuprofen, aspirin and placebo is compared in a double-blind study. The results are reported showing ibuprofen to have greater therapeutic benefit than placebo whereas aspirin did not. Methods of providing pain relief after tonsillectomy and the relative clinical merits of ibuprofen and aspirin are discussed.

A double-blind comparison of a new ibuprofen-codeine phosphate combination, codeine phosphate, and placebo in the relief of postepisiotomy pain.

In a double-blind single-dose study, the analgesic effect of a new ibuprofen-codeine phosphate combination was compared with those of codeine phosphate alone and placebo for the relief of moderate and severe postepisiotomy pain. In the 113 patients studied, combination therapy was superior to codeine phosphate alone and to placebo, the difference between the combination and codeine phosphate alone reaching statistical significance (P less than 0.05) after two hours. The few side effects reported were not of a serious nature.