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SummaryA Double-Blind Crossover Study Was Carried Out In 24 Patients With Osteoarthrosis Of The Hip Or Knee To Compare The Efficacy Of A 1200 mg Tolmetin Daily Dose With A 600 mg Daily Dose, Each Given For 2 Weeks. Both Regimens Were Well Tolerated And Appeared To Give Satisfactory Relief Of Pain, But No Differences In Response Between The Two Dosages Were Noted Either Because The Number Of Patients Involved Were Small Or Because The Methods Of Monitoring Clinical Improvement Were Not Sufficiently Sensitive. A Further Double-Blind Crossover Study Was Carried Out In 40 Patients To Compare The Efficacy Of 1200 mg Tolmetin Daily With 150 mg Ketoprofen Daily, Each Drug Being Given For 2 Weeks After An Initial 1-Week Period On Placebo. Pain Was Monitored Using A Visual Analogue Line Technique And Significant Differences Were Found Between Both Active And Placebo Periods. Analysis Of The Biochemical Monitoring Of Both Trials Showed Statistically Significant Rises In Blood Urea For All Active Treatment Periods. There Were No Concomitant Changes In Serum Creatinine, Suggesting This Effect To Be Extra-Renal In Origin. In General, Side-Effect Incidence Was Low; 1 Patient Withdrew From Ketoprofen Treatment Because Of Weight Increase And Urine Retention.

SummaryAn open, multi-centre study was carried out in patients with various moderate to severe painful conditions to assess the effectiveness of zomepirac in relieving pain. Patients were treated with 300 mg to 600 mg zomepirac daily for 7 days. Data from 15,484 patients have been analyzed. Most of the patients (75%) were already being treated with an analgesic on entry and more than half of them had been prescribed this by their doctor. Almost half, however, had still been in pain for more than 4 weeks before receiving zomepirac. An analysis of pain severity assessments showed a reduction from an initial score of 2.4 to 1.3 (on a 4-point rating scale). Global responses were recorded and 71.7% of the patients were considered to have improved according to the opinion of both doctors and patients, with the best response (84.1%) being observed in those with acute painful states such as sprains, strains and fractures and with pain of short duration. Pain frequently disrupts sleep, and 46.2% of patients reported their sleep as 'bad' or 'very bad' on entry to the study. After treatment, this figure was reduced to 15.1%. The side-effects reported, which were mainly gastro-intestinal, were mild in general and led to withdrawal of only 7.2% of the patients before completion of treatment.

SummaryAn open, multi-centre study was carried out in patients with various moderate to severe painful conditions to assess the effectiveness of zomepirac in relieving pain and improving sleep quality. Patients were treated with 300 mg to 600 mg zomepirac daily for 7 days. Data from 5819 patients have been analyzed so far in the ongoing study. Most of the patients (73%) were already being treated with an analgesic on entry and more than half of them had been prescribed this by their doctor. Almost half, however, had still been in pain for more than 4 weeks before receiving zomepirac. Assessments of pain severity and sleep quality on entry and after treatment indicated that 70% of the patients were considered to have improved, according to the opinion of both doctors and patients, with the best response being observed in those with acute painful states such as sprains, strains and fractures and with pain of short duration. The side-effects reported, which were mainly gastro-intestinal, were mild in general and led to withdrawal of only 7% of the patients before completion of treatment.

SummaryA double-blind crossover study was carried out to compare the efficacy and tolerance of tolmetin sodium and naproxen in patients with ankylosing spondylitis. Patients were only included in the study after demonstration that their disease was in an active phase, this being accomplished by monitoring pain and stiffness before and after 1 week's placebo therapy. Only those patients whose condition deteriorated were admitted to active treatment. Also, patients were carefully selected for those with unequivocal diagnosis. A total of 88 patients was screened and 34 enrolled in the study. Of these, 27 patients completed 4-weeks' treatment with each drug as planned. Pain and stiffness improved on active treatments when compared to placebo, nocturnal pain and immobility stiffness significantly so. Spinal mobility also improved; the decrease in occiput-wall distance was statistically significant for tolmetin sodium when compared to both naproxen and placebo. Comparative global assessments and drug preference were similar for both drugs. Side-effect incidence was acceptable; I patient withdrew from naproxen with limiting gastro-intestinal problems and 1 from tolmetin sodium treatment because of lack of effect.

SummaryA double-blind crossover study was carried out in 24 patients with rheumatoid arthritis to investigate the relative efficacy of tolmetin (1600 mg/day)and phenylbutazone (400 mg/day). Each drug was given for 4 weeks, preceded by a 2-week wash-out period during which patients received paracetamol alone for pain relief. Assessments were made of duration of morning stiffness, grip strength, articular index, joint size, and degree of pain. Both drugs produced significant improvements compared to paracetamol, particularly in pain relief and, apart from morning stiffness, tolmetin proved equally effective as phenylbutazone. Three patients (2 on tolmetin and 1 on phenylbutazone) were withdrawn because of side-effects. In general, however, both drugs gave rise to only minor side-effects.

SummaryA double-blind crossover study was carried out in 21 patients with osteoarthrosis of the hip to compare the effectiveness and tolerance of 1200 mg tolmetin sodium daily with 75 mg indomethacin daily. Each drug was given in 3 equally divided doses daily for a period of 2 weeks, both active treatment periods being preceded by 1 week on placebo. Active treatment sequence was at random. Patients were seen again after 1, 3, 4 and 6 weeks and assessments made of pain at rest, on standing, on walking, degree of sleep disturbance, and degree of limitation of everyday activity. Intermalleolar distance was also measured. A record was kept of the clinician's opinion of change with treatment, any side-effects and the patient's preference. The results from 19 patients completing the study showed that both drugs produced a good analgesic response, particularly in night pain, and most patients found their incapacitation decreased with active treatment as compared to placebo. The few side-effects reported were mild and transient, except in 1 patient who withdrew from tolmetin sodium treatment because of limiting gastrointestinal symptoms.