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Nonsteroidal antiinflammatory drugs in rheumatoid arthritis and osteoarthritis - Support for the concept of ''responders'' and ''nonresponders''


Walker, JS and Sheather-Reid, RB and Carmody, JJ and Vial, JH and Day, RO, Nonsteroidal antiinflammatory drugs in rheumatoid arthritis and osteoarthritis - Support for the concept of ''responders'' and ''nonresponders'', Arthritis & Rheumatism, 40, (11) pp. 1944-1954. ISSN 0004-3591 (1997) [Refereed Article]

DOI: doi:10.1002/art.1780401105


Objective. A range of functional, biochemical, and psychological indicators was used to test the concept of 'responders'/'nonresponders' and to seek predictors of response to 2 nonsteroidal antiinflammatory drugs in 9 patients with rheumatoid arthritis (RA) and 11 with osteoarthritis (OA). Methods. In a balanced, randomized, double-blind latin-square study design that involved four 4-Week treatment periods patients received ketoprofen or piroxicam (each for 2 of the 4 periods). Clinical and laboratory responses (pain, tenderness, swelling, patient and physician global assessments, acute- phase protein levels and disability) were assessed in the last 2 weeks of each period. Responders were those who showed >30% improvement in at least 5 of 7 measures of disease activity. Mood was also assessed. Results. At baseline, variables were higher in RA than in OA patients. The drugs produced clear improvements in patients' visual analog scale scores, physicians' overall assessments and patients' responses to the McGill Pain Questionnaire, as well as plasma prostaglandin concentrations. In patients with either RA or OA, responders could be distinguished from nonresponders; about one-third of patients were unambiguous responders. In RA, there were responder/nonresponder differences in lymphocyte counts, erythrocyte sedimentation rate (ESR), and levels of tumor necrosis factor or, but no differences were seen in OA patients. However, caution in interpretation of the data is necessary because of the small number of patients. Responders had improved mood scores compared with nonresponders in both disease groups. Baseline ESR and white blood cell counts were correlated with responder status in RA patients. Conclusion. This study provides support for the responder/nonresponder concept. It also indicates that in RA, pretreatment ESR and lymphocyte counts are possibly useful indicators of therapeutic response.

Item Details

Item Type:Refereed Article
Research Division:Biomedical and Clinical Sciences
Research Group:Clinical sciences
Research Field:Rheumatology and arthritis
Objective Division:Health
Objective Group:Clinical health
Objective Field:Clinical health not elsewhere classified
UTAS Author:Vial, JH (Associate Professor Janet Vial)
ID Code:11230
Year Published:1997
Web of Science® Times Cited:50
Deposited By:Clinical Sciences
Deposited On:1997-08-01
Last Modified:2011-08-12

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