Relationship between clinical efficacy and laboratory correlates of inflammatory and immunologic activity in rheumatoid arthritis patients treated with nonsteroidal antiinflammatory drugs

✍ Scribed by John J. Cush; Hugo E. Jasin; Regina Johnson; Peter E. Lipsky

• Publisher: John Wiley and Sons
• Year: 1990
• Tongue: English
• Weight: 1002 KB
• Volume: 33
• Category: Article
• ISSN: 0004-3591
• DOI: 10.1002/art.1780330504

✦ Synopsis

Eighteen rheumatoid arthritis (RA) patients, who had been treated with nonsteroidal antiinflammatory drugs (NSAIDs) only, were enrolled in a 12-week, open-label, randomized protocol to determine whether clinical responses might be associated with improvement in laboratory measures of inflammation and immunologic activity in RA patients treated with NSAIDs. Following a 2-week drug washout period, patients were given either long-acting ibuprofen (2,400 mg/day) or flurbiprofen (200 mglday); clinical, laboratory, and immunologic assessments were done biweekly for 10 weeks. A clinical efficacy index, utilizing a combination of measures of disease activity, identified 7 "responders" and 10 "nonresponders" (1 patient discontinued therapy because of a rash). Flow cytometric analysis revealed no abnormalities in the numbers of circulating CD3+, CD4+, or CD8+ lymphocytes in the 17 patients. The density of these T cell markers at enrollment was similar in patients and control subjects. However, following the 2-week drug washout, significant worsening of morning stiffness, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) was accompanied by a significant decrease (P 5 0.05) in the density of these T cell surface determinants, as is characteristic of activated T cells. After 10 weeks of NSAID therapy, increased density of CD3, CD4, and CD8 was observed in 47%, 73%, and 50% of the patients, respectively.