Parenteral nutrition

A comparative study of flurbiprofen and indomethacin in rheumatoid arthritis

A double-blind crossover trial of 200 mg flurbiprofen daily and 100 mg indomethacin daily, each given for 2 weeks separated by a 1-week placebo washout period, was carried out in 30 patients with rheumatoid arthritis. The results were analyzed for the 26 patients with complete records. No statistically significant differences were found between the two treatments with regard to subjective impression of pain severity, duration of morning stiffness, grip strength, joint size, haemoglobin and erythrocyte sedimentation rate. When the results for each treatment period were compared to baseline and both drugs considered individually, there was a statistically significant improvement from baseline. During the flurbiprofen treatment period the erythrocyte sedimentation rate showed a statistically significant fall, but not with indomethacin. During the placebo washout period between the active therapies, there was a statistically significant worsening in all parameters apart from the level of haemoglobin and erythrocyte sedimentation rate. These assessments showed little change. Five patients reported side-effects with indomethacin, and 1 with flurbiprofen. No side-effects were reported during the placebo period and although 4 patients were withdrawn, none was withdrawn because of side-effects. Patient preference was for flurbiprofen.

Flurbiprofen in rheumatoid arthritis therapy

Preliminary findings are reported from an open study of 300 mg flurbiprofen daily in 24 patients and from 6 out of 30 patients treated so far in a double-blind crossover comparison of 300 mg flurbiprofen daily and 150 mg indomethacin daily in the treatment of rheumatoid arthritis. The results indicate that flurbiprofen is effective in relieving symptoms and is better tolerated than indomethacin. Using an experimental model in rats to assess the anti-inflammatory activity of flurbiprofen, data suggest that flurbiprofen is unable to prevent an immunological type of inflammation but is capable of modifying the type and extent of cellular infiltration.

Treatment of ankylosing spondylitis with flurbiprofen and indomethacin

In a parallel, double-blind and randomized trial of 6-weeks' duration, flurbiprofen (150 mg to 200 mg daily) was compared with indomethacin (75 mg to 100 mg daily) in the management of 26 patients with active ankylosing spondylitis. None of the patients in either group withdrew from the study because of lack of efficacy of the drugs. Both drugs were equally effective in the relief of pain and tenderness of the affected joints. Overall subjective improvement, assessed by the patient and the investigator at the end of the trial, was present in 90% of the patients in the flurbiprofen group and in 75% of those in the indomethacin group. The mean values of all the spinal motion tests improved in the flurbiprofen group but not in the indomethacin group. Statistically significant improvement in the Schober test was achieved in the flurbiprofen group and in chest expansion in the indomethacin group. Characteristic untoward effects related to the central nervous system and gastro-intestinal tract were present in a few patients in both groups.

Controlled clinical trial comparing flurbiprofen and phenylbutazone in patients with rheumatoid arthritis

Preliminary results in 12 patients with rheumatoid arthritis are presented from an on-going double-blind, between patient comparison of flurbiprofen and phenylbutazone. Patients received either 300 mg flurbiprofen daily or 400 mg phenylbutazone daily over a 2-week treatment period. Two patients treated with phenylbutazone developed a rash, and treatment was discontinued in 1 of them after Day 2.