[Clinical experience with the use of piroxicam in fast-dissolving sublingual capsules in acute recurrent osteoarthritis]. / Esperienza clinica sull'impiego del piroxicam compresse sublinguali a rapida dissoluzione nell'osteoartrosi riacutizzata.

Open, non comparative study to evaluate the efficacy and safety of piroxicam Fast Dissolving Dosage Form (FDDF) for sublingual administration in treatment of reacutized osteoarthritis. Fifty-four patients with flare-ups of osteoarthritis involving various joints were enrolled in the study. They were treated with 20 mg/die piroxicam sublingual tablets for a total of 4 weeks. Drug efficacy was evaluated on the basis of the variation of spontaneous pain, pain on passive motion, functional limitation and capacity of performing a specific activity. Intensity of spontaneous pain on the first day showed a statistically significant improvement (p < 0.0001) only 15 minutes after the drug administration. This improvement in pain intensity increased until day 3. All other efficacy parameters showed a statistically significant improvement (p < 0.0001) 7 days after the beginning of treatment. Local and systemic tolerability was good. No patient showed local side effects; only 6 patients experienced systemic side effects. In conclusion, piroxicam sublingual tablets for treatment of osteoarthritis flare-ups showed analgesic efficacy already 15 minutes after drug administration, and good anti-inflammatory efficacy with good local and systemic tolerability.

[Calcifediol and calcitonin in the therapy of rheumatoid arthritis. A short-term controlled study]. / Calcifediolo e calcitonina nella terapia dell'artrite reumatoide. Studio controllato a breve termine.

A short-term study (30 days) has been carried out on 45 patients suffering from rheumatoid arthritis with radiologically verified osteoporosis and definite pain symptomatology. The patients were divided at random into three groups (A, B, C) of 15 each. Group A was given basic therapy (calcium, dichlrophenac, nor-androstenolone) with addition of calcifediol. Group B received basic therapy plus calcitonine in paraphysiological doses. Group C was treated with basic therapy only (highly effective on its own). Observation and treatment were brief but able to provide useful indications regarding the implementation of longer courses of treatment (3-6 months). At the end of treatment, results were submitted to biometric control. With the aid of statistics it can thus be stated that alkaline phosphatase and hydroxyprolinuria fall in group B (basic treatment + calcitonine) and this suggests that the treatment causes some improvement in the exchangeable bone calcium pool. The values of these parameters also fall with the addition of calcifediol to basic therapy, but this fall is not very high. Pain symptomatology is also favourably affected, and to a statistically significant extent, by the three treatments: group A patients (basic + calcifediol) show greater improvement compared with straightforward basic therapy, but the best results are encountered in group B, treated with an association of basic and calcitonine. No side-effects were observed.

Collagenase activity in human synovial fluids from joint diseases of diverse etiology.

The content of collagenase in latent as well as in apparent active form has been determined in synovial fluids from 21 patients with rheumatoid arthritis, 16 with non-rheumatoid inflammatory joint diseases, and 15 with degenerative joint disease. Collagenase activity was measured before and after activation of the latent enzyme by NaSCN treatment. Before activation, collagenase activity was present in the synovial fluids from 1 case of rheumatoid arthritis, 3 cases of degenerative joint disease, and 1 case of Behçet's syndrome. An excess of inhibitor was present in inactive synovial fluids. The incidence of collagenolytic activity markedly increased after treatment with NaSCN. When NaSCN-dependent collagenolytic activity was present, its value was of the same order of magnitude in all patients regardless of disease type. The diagnostic value of the finding of collagenase activity in synovial fluid, and the physiological meaning of the enzyme with reference to joint diseases, are discussed.