Clinical measurement of the anti-inflammatory effects of salicylates in rheumatoid arthritis.

Abstract

Joint size may be measured serially with reasonable accuracy under controlled conditions for the clinical assessment of inflammation in rheumatoid arthritis. The patient''s preference and grip strength indicate improvement on drugs which are anti-inflammatory or analgesic agents; under defined conditions joint size is an index of specific antiinflammatory effect. The reduction of joint size by prednisone, an antiinflammatory agent, is contrasted with the absence of change on paracetamol. High dosage of salicylate, unlike dosage, is associated with reduction in joint size. There is no detectable difference between low dosage of salicylate and placebo in their effect on joint size. High dosage of salicylate may have a clinically measurable anti-inflammatory effect. If suppression of inflammation is desirable in rheumatoid arthritis high dosage of salicylate is indicated independently of symptoms. Unlimited use of high dosage of salicylate in trials may affect the findings. Low dosage modifies the response if given in combination. Salicylate intake should be eliminated from comparative trials of anti-inflammatory agents. The plan of this trial provides a simple method for the clinical assessment of the anti-inflammatory properties of a rapidly acting drug.