Vitamin B1, B6 and B12 are frequently prescribed in rheumatic diseases as analgesic drugs. If some fundamental data suggest their analgesic potential, especially in animal models, there are very few clinical trials in human demonstrating their efficacy in rheumatology. Looking at these data from the literature, we should reconsider our prescription of vitamin B.

Humans↗

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Captopril-induced lupus.

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Captopril↗

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[Non-steroidal anti-inflammatory agents and cyclooxygenases].

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Animals↗

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[Methotrexate and non-steroidal anti-inflammatory agent combination in rheumatoid arthritis].

It is well known that methotrexate (MTX), used at high dosage in cancer patients, must not be combined with a non-steroidal anti-inflammatory drug (NSAID) because of high risk of side effects; prescribed at low dosage (< or = 15 mg per week) in rheumatoid arthritis patients, MTX is often combined with an NSAID. Some cases reported in the literature underline the potential toxicity of the association of low dose MTX with an NSAID, but most of the pharmacological studies do not confirm this hypothesis. Except for salicylates, NSAIDs do not affect the absorption, distribution, protein binding, area under the curve, half-life, or the elimination of MTX. Therefore, if necessary, MTX (< or = 15 mg per week) can be combined with an NSAID during the treatment of rheumatoid arthritis.

Anti-Inflammatory Agents, Non-Steroidal↗

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[Do some drugs have adverse effects on cartilage?].

The potential chondrotoxicity of drugs is very difficult to appreciate because of the difficulties involved in evaluating the evolution of cartilage in human beings. This article attempts to summarize the data from the literature concerning the hypothetical chondrotoxicity of non steroidal anti-inflammatory drugs, fluoroquinolones, intra-articular injections of corticosteroids, and other drugs.

Adrenal Cortex Hormones↗

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[Value of delayed botulinum toxin injection in esotropia in the child as first line treatment].

PURPOSE: Evaluation of botulinum toxin to treat esotropia in children over 3 years old. MATERIAL AND METHODS: Eight children (6 boys and 2 girls), aged from 3 to 6 years (mean 4), underwent bilateral injection of 1.25 UI botulinum toxin Botox in medial rectus muscles, under general anesthesia. Preoperative diagnosis was infantile esotropia in 7 cases, and decompensated esophoria in 1 case. Six children had alternating isoacuity before injection, and two had amblyopia. Mean follow-up was 1.8 months (6 to 24 months). RESULTS: One transient exotropia, and one transient ptosis were reported. Lasting orthotropia was achieved in four children (including one who presented again spasms in near vision), and lasting angle reduction in another child. Another child had late recurrence at 18 months. The injection was a failure for the two amblyopic children. DISCUSSION: Botulinum therapy allowed to avoid surgery in three cases, and to perform a more limited operation in one case. CONCLUSION: Botulinum toxin injection in extraocular muscles is of interest in infantile esotropia as a first treatment, even in children over 3 years. The success relies principally on the absence of deep amblyopia, and muscular elongation troubles. However, the use of botulinum is limited, because it requires general anesthesia, and because of its price.

Age Factors↗