A double-blind crossover study comparing tolmetin and indomethacin in the treatment of rheumatoid arthritis

Summary

A double-blind crossover trial was carried out in 21 patients with classical or definite rheumatoid arthritis to compare the efficacy of tolmetin (1600 mgper day) with that of indomethacin (100 mg per day) and placebo. After a 1-week wash-out period on paracetamol, patients were treated for 1 week with either tolmetin or indomethacin and then for 1 week on placebo before being crossed over to the alternative drug for a final week. At the end of each treatment period, assessments were made of the severity of morning stiffness and pain, articular index, digital joint size, grip strength, andpatients assessment of well-being and treatment period preference. Tolmetin and indomethacin showed comparable efficacy, and both proved significantly superior to placebo and paracetamol in all parameters, except digital joint size and patients' well-being. One patient was withdrawn because of side-effects on both drugs, but few other side-effects were reported.

Key Words::

• Tolmetin
• Indomethacin
• anti-inflammatory agents
• arthritis
• rheumatoid