Abstract
The inter-individual differences in response to indomethacin have been studied in patients with rheumatoid arthritis. In patients initially thought to be non-responsive to indomethacin, this failure to respond has been confirmed compared to a similar group of responsive patients. No differences in the plasma indomethacin pharmacokinetics, protein binding of indomethacin, urine excretion of indomethacin, platelet aggregation with collagen, platelet production of malonyldialdehyde, or urinary excretion of prostaglandin metabolite were seen between the two groups. However, while there was a positive correlation between the plasma indomethacin concentration and the percentage inhibition of platelet malonyldialdehyde production in responders (r = 0.475, p <0.01): in non-responders this correlation, while significant, was negative (r = 0.504, p <0.01). This observation suggests a possible biochemical difference between responders and non-responders.
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