Indomethacin and Phenylbutazone: A Comparison

Abstract

A double-blind cross-over trial was carried out to compare indomethacin, 75 mg. daily, with phenylbutazone, 300 mg. daily, each being given for a period of 28 days to patients with active rheumatoid arthritis. No significant differences were found between the two groups in the relief of symptoms, but the results obtained were indicative of greater reduction of early-morning stiffness on phenylbutazone and of joint swelling on indomethacin. The personal preference, expressed at the end of the trial, was in favour of phenylbutazone. In a mixed group of patients treated over two and a half years indomethacin was effective in improving the symptoms of osteoarthritis (65.3%) and of ankylosing spondylitis (68.7%). In rheumatoid arthritis failures were more frequent, a satisfactory response being recorded in 50.5% of cases. Side-effects on indomethacin capsules, at an average maintenance dose of 75 mg. daily, occurred in 36.6% of patients in the mixed group. The common side-effects were headache giddiness, muzziness, nausea, and vomiting. Dyspepsia was not a major problem, occurring in 7.92% of patients ; it was only rarely dose-dependent and occurred at any time during long-term administration in contrast to the other side-effects, which were dependent on dose and developed almost always within the first 14 days of treatment. © 1965, British Medical Journal Publishing Group. All rights reserved.