Indomethacin in Rheumatoid Arthritis: An Evaluation of its Anti-inflammatory and Side Effects

Abstract

In a double-blind crossover clinical trial occupying 10 week indomethacin was given in capsule form for four consecutive weeks, starting with a daily dose of 50 mg. and increasing by one 25-mg. capsule a week to a maximum of 125 mg./day The results on 30 patients with classical or definite rheumatoid arthritis are tabulated and discussed. With the criteria of assessment based on the systemic inde2 and articular index of Lansbury and measuring finger-joint swelling by means of jewellers' ring-gauges it was not possible to show that indomethacin produced any antiphlogistic effect that held statistical validity. The detumescent and analgesia effects demonstrated were shown to be the result of placebo and learning factors. A tendency for indomethacin to accelerate the rate of erythrocyte sedimentation was revealed, and evidence for a specific anti-fatigue effect of the drug in rheumatoid arthritic patients is presented. Side-effects are listed. Though they occurred more often with indomethacin, the incidence, type, and pattern were the same with both drug and placebo. The inference is made that suggestion played a part in determining both the incidence and the variety of side-effects encountered in the trial. © 1967, British Medical Journal Publishing Group. All rights reserved.