RESUMO
The effect of intra-articular injections of corticosteroids repeated over a period extending from four to 15 years on the radiological appearances of knee joints affected by rheumatoid arthritis and osteoarthritis has been studied. In 65 cases, the X-ray films of 15 showed no deterioration, 38 showed minimal or moderate deterioration, 10 showed marked deterioration and only 2 showed gross deterioration. The results do not support the contention that repeated intra-articular injections of corticosteroids will inevitably lead to rapid joint destruction. The authors are of the opinion that intraarticular injections of corticosteroids, if used judiciously, have an important part to play in the management of chronic arthritis.
Assuntos
Corticosteroides/administração & dosagem , Injeções Intra-Articulares/efeitos adversos , Articulação do Joelho , Corticosteroides/uso terapêutico , Artrite Reumatoide/diagnóstico por imagem , Artrite Reumatoide/tratamento farmacológico , Humanos , Hidrocortisona/administração & dosagem , Hidrocortisona/uso terapêutico , Articulação do Joelho/diagnóstico por imagem , Osteoartrite/diagnóstico por imagem , Osteoartrite/tratamento farmacológico , Prednisolona/administração & dosagem , Prednisolona/uso terapêutico , Radiografia , Estudos Retrospectivos , Triancinolona/administração & dosagem , Triancinolona/uso terapêuticoRESUMO
In a single centre double-blind crossover study in eighteen patients with established rheumatoid disease, a new slow release aspirin ("slow aspirin") was compared with plain aspirin with respect to patient tolerability and gastric mucosal damage as observed at gastroscopy. "Slow aspirin" was significantly better than plain aspirin with regard to gastroscopic findings. With "slow aspirin", the gastric mucosal appearances were definitely better in eight patients, worse in two, and eight showed no difference. There was a high incidence of gastric ulceration or erosions in the groups as a whole (39%) but few patients complained of dyspepsia. There was little difference in the ability of both plain and "slow aspirin" in controlling the patients' joint symptoms. Evidence has been provided to suggest that "slow aspirin" is less injurious to the gastric mucosa. In an attempt to reduce gastric mucosal damage due to prolonged aspirin treatment it is therefore concluded that "slow aspirin" merits consideration in the management of chronic rheumatoid disease.
Assuntos
Artrite Reumatoide/tratamento farmacológico , Aspirina/administração & dosagem , Adulto , Idoso , Aspirina/efeitos adversos , Aspirina/uso terapêutico , Preparações de Ação Retardada , Método Duplo-Cego , Tolerância a Medicamentos , Dispepsia/induzido quimicamente , Mucosa Gástrica/efeitos dos fármacos , Mucosa Gástrica/patologia , Gastroscopia , Humanos , Pessoa de Meia-Idade , Úlcera Gástrica/induzido quimicamente , Úlcera Gástrica/patologiaRESUMO
A double-blind crossover study was carried out in 21 patients with osteoarthrosis of the hip to compare the efficacy and tolerance of feprazone (600 mg/day) and ibuprofen (1200 mg/day), each drug being given for 4 weeks. No statistically significant changes were noted in any of the objective parameters measured, but patients' subjective assessments of pain showed a significant improvement in pain levels (p less than or equal to 0.05, day and night) after feprazone. One patient, who had reported a rash at initial assessment, was withdrawn at the end of the first treatment period (on feprazone) when he developed a severe rash, 1 patient was withdrawn because of exacerbation of symptoms (on ibuprofen) and a further patient was lost to follow-up because of intercurrent illness. Both drugs were well tolerated by the other patients and the few side-effects reported were minor in nature.
