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The physiology and pathology of dysmenorrhea in adolescent girls has become clear in the past 5 years. Although the prime cause of the disorder has not been identified, the obvious rise in PGF2 alpha prostaglandins is an objective biologic sign. As a result, more specific treatment has become possible with more definite and established care of this "condition" which is often distressing to the teenage girl affected.

The therapeutic efficacy of N-(2,6-dichloro-m-tolyl)anthranilic acid, sodium salt (meclofenamate sodium, Meclomen) in the management of rheumatoid arthritis was clearly established in four large, double-blind, controlled multicenter studies in 757 patients. In one study, 200 mg/day of meclofenamate sodium was compared with 300 mg/day and placebo for six weeks. Another compared meclofenamate sodium, 300 mg/day, with acetylsalicylic acid (ASA), 3.6 g/day, for eight weeks. Two other long-term studies compared meclofenamate sodium and ASA, 300 mg/day and 3.6 g/day, respectively, for six months; in one, the patients were allowed to receive concomitant gold salts or steroids, while in the other, they were not. Both objective and subjective measures showed that meclofenamate sodium was as effective as ASA and superior to placebo. Gastrointestinal reactions, most commonly diarrhea, were seen more often with meclofenamate sodium than with ASA or placebo, but withdrawal for adverse reactions did not differ significantly between treatment groups. ASA-associated side effects such as tinnitus and deafness were not experienced by the patients receiving meclofenamate sodium. Meclofenamate sodium is a safe, effective agent for the treatment of rheumatoid arthritis.

N-(2,6-Dichloro-m-tolyl) anthranilic acid, sodium salt (meclofenamate sodium, Meclomen) was compared to placebo in two controlled multicenter trials of similar design, one in 180 patients with osteoarthritis of the hip and the other in 237 patients with osteoarthritis of the knee. Following one week on placebo to establish a baseline, patients were given meclofenamate sodium (300 mg/day) or placebo for a four-week double-blind controlled period of treatment. Improvement with meclofenamate sodium consistently exceeded that with placebo. In the hip and knee trials, the differences were statistically significant for at least three of the four weekly visits in reduction of pain on walking, pain on starting motion, pain on passive motion, night pain (knee only), and tenderness. Early in the study, statistically significant improvement was also observed in tenderness measures of the knee and fabere measures of hip function. At each weekly observation, significantly better global assessment scores of patient condition were reported by the patients (p less than 0.005) and their physicians (p less than 0.01) in the group receiving meclofenamate sodium in both the hip and knee trials. Overall global improvement was reported in 76% of the patients on drug and 42% of those on placebo. 31% of the patients receiving meclofenamate sodium and 23% receiving placebo reported adverse reactions. Gastrointestinal reactions were more frequent among the patients receiving the drug. The improvement achieved during the double-blind phase was maintained or increased in 359 patients who continued into long-term therapy with meclofenamate sodium. Meclofenamate sodium was judged effective and safe in the treatment of osteoarthritis of the hip and knee.