A randomized crossover trial of micro-encapsulated aspirin (Levius) and aloxiprin (Palaprin Forte) was carried out on thirty-three hospital outpatients with rheumatoid arthritis. Both preparations improved the clincial status of the patients. The difference in response to the two preparations was not significant, except for effect on functional status where the micro-encapsulated aspirin was found to be significantly better at the 5% level. Apart from six complaints of constipation with aloxiprin compared with only one with Levius, the side-effects were similar. The trial has shown that Levius can be conveniently given in divided doses thrice daily without loss of efficacy.
The effects of niflumic acid (trifluoro-methyl-3-phenylamino-2-nicotinic acid) and of aloxiprin (aluminium acetyl-salicylate) in patients with rheumatoid arthritis were compared in a double-blind cross-over trial. Check-up examinations prior to the institution and after the termination of the therapy, as well as after individual treatment periods of two weeks with alternating sequential administration of the two drugs, were carried out with a standardized method. The assessment included subjective (pain intensity) and objective criteria (Lansbury's index), as well as laboratory results (erythrocyte sedimentation rate, uricaemia). With the exception of the articular index disclosing a superior effect of niflumic acid, the other criteria showed no statistically significant differences between the effects of the two drugs.
Two studies are reported with tolmetin sodium. The first compared tolmetin sodium, phenylbutazone and placebo in rheumatoid arthritis. The second compared tolmetin sodium and aloxiprin in osteoarthritis and soft tissue rheumatism. In the first study, a double-blind crossover trial involving 12 patients, tolmetin sodium (1600 mg daily) was shown to be superior to placebo and comparable to phenylbutazone (400 mg daily). The reductions in morning stiffness and pain were statistically significant when compared to placebo. Tolmetin sodium and aloxiprin were compared in the treatment of osteoarthritis in a single-blind study which investigated efficacy and safety over a 3-month period. Initial dosages were 1600 mg tolmetin sodium and 6 g aloxiprin (equivalent to 5 g aspirin) daily. Thirty-four patients were enrolled in the study. Both drugs produced an improvement over the 3-months treatment period. The reduction in pain was statistically significant. The dosage of tolmetin sodium remained at 1600 mg daily for the 3-month duration of the study but side-effects necessitated the reduction of the dosage of aloxiprin in many patients and after 3-months' treatment the mean dosage was 4 g daily. Five patients withdrew from the tolmetin sodium group and 11 from the aloxiprin group. Adverse reactions including limiting side-effects, were about twice as common with aloxiprin compared to tolmetin sodium.
The inhibitory potency and duration of action of single doses of aspirin B.P., claradin (a low sodium effervescent preparation of acetylsalicylic acid) and aloxiprin (an aluminium co-polymer of acetylsalicylic acid) on platelet release reaction induced by adenosine diphosphate (ADP) were studied in seventeen volunteers. Aspirin B.P. and claradin at 300 mg and 150 mg inhibited release reaction in all subjects within 24 hr; 75 mg was effective only in some subjects. Aloxiprin gave less marked response and a dose of 300 mg was required to inhibit the effect in all volunteers. Where occurring, inhibition of release reaction persisted for three days after treatment with all preparations and restoration to normal occurred in most subjects by the sixth day. A daily dose of 50 mg claradin for 12-15 days in five volunteers produced complete inhibition of release reaction for most of the treatment period. Inhibition of release reaction took up to 3 days to occur. Normal aggregation returned within 3 days of discontinuing treatment in all subjects. A daily dose of 25 mg claradin gave inconsistent results. It is suggested that if a trial of acetylsalicylic acid be undertaken for the prevention of arterial thrombosis based on its ability to inhibit platelet release reaction then a daily dose of 50 mg would be sufficient.
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