The Antirheumatic Effect of Indomethacin

Abstract

Summary and Conclusions85 patients have been treated with indomethacin (as Indocid capsules) with an average treatment period of 20 weeks (4—30 weeks). Total treatment period 1700 weeks. The material consists of 55 rheumatoid arthritis, 19 arthrosis, 8 gout and 3 spondylarthritis.The dosage used was 25 mgr. Indocid capsules × 3 daily increasing by 1 capsule daily per week till therapeutic effect was reached (max. dose 150 mgr. daily). The average daily dose used on rheumatoid arthritis was 100 mgr., on arthrosis 78 mgr.Acute gout patients received 300 mgr. daily for 2 days, then 150 mgr. daily 1—2 weeks.Spondylarthritis patients received 150—200 mgr. daily.The antirheumatic effect was assessed as an improvement in functional capacity (F.C.) or as a diminishing in disease activity. It was shown that F.C. increased very considerably in 57 % of rheumatoid arthritis cases and increased distinctly in another 18 % during use of Indocid.It was shown that F.C. increased very considerably in 80 % of arthrosis. Disease activity diminished in 41 % the rheumatoid arthritis cases.Toxic side effects appeared in 20 patients — with 30 symptoms. These side effects appeared in 58 weeks out of 1700 total treatment weeks = 3.5 %.The side effects have not been serious in any case, and quickly disappeared when medication was reduced or stopped. Afterwards the dosage could be gradually increased until therapeutic effect was reached.Headache and vertigo was the most bothersome of the side effects.There was no case of blood dyscrasia.One patient developed duodenal ulcer during the medication. The dose was reduced whilst he was put on ulcus diet. There was no occult bleeding after two weeks. He has had no more dyspeptic symptoms and is now on full therapeutic dose.No other occult bleeding has been detected.5 patients did stop the treatment because of the following side effects: 1 patient discontinued treatment when he got diarrhea, nausea, vomiting and abdominal pain.1 patient stopped because of somnolens.2 patients developed urticaria reactions and stopped treatment. Both these patients had previously shown allergic reactions to a series of different medicines.Interesting non-toxic side effects noticed during treatment were:In 3 psoriatic cases rash disappeared during treatment (in one it has reappeared later).1 pyorrhea cleared up during one month's treatment.1 phlebitis cleared up in approx. one weeks' treatment.Steroid doses could be reduced in 11 out of 34 patients. As a careful conclusion of these results, one may say that Indocid is a very promising compound, which, when used properly, in gradually increased dosage, does not appear to give serious side effects, and has a favourable effect in treatment of rheumatoid arthritis and gout, and gives very favourable results on arthrosis and possibly spondylarthritis.