The Effects of Some Anti-inflammatory Drugs on the Acute-phase Proteins in Rheumatoid Arthritis

Abstract

In patients with rheumatoid arthritis neither aspirin nor indomethacin influenced the levels of the ESR or two acute-phase proteins, C-reactive protein, and haptoglobin. The ESR is mainly dependent on plasma fibrinogen, itself an acute-phase protein; we therefore conclude that non-steroid anti-inflammatory drugs do not influence the acute-phase protein response in rheumatoid arthritis. The finding explains why in some circumstances especially when aspirin-like drugs are given, clinical and laboratory results may diverge. We suggest that the non-steroid anti-inflammatory drugs provide symptomatic relief only and that there is no point in assessing them by other than clinical observations. Adrenal steroids, on the other hand, profoundly affect the acute-phase protein response; the effect is so marked as to suggest that they are not merely more powerful anti-inflammatory agents but act differently. As it has previously been established that the course of rheumatoid arthritis is reflected in the acute-phase protein levels the ability to influence them implies also an ability to alter the course of the disease. We suggest that drugs in this group can best be studied by serial measurements of the acute-phase proteins.