Reiter's syndrome: evaluation of proposed criteria.
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Biomedical subjects
Publications and source records attributed to R F Willkens.
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Flurbiprofen (150-200 mg daily) and phenylbutazone (300-400 mg daily) were compared in the management of 27 patients with active ankylosing spondylitis. This was a parallel, double-blind, and randomized trial of 6 weeks duration. Both drugs were equally effective in the relief of pain and tenderness of the affected joints. Overall subjective improvement, assessed by the patient and the investigator at the end of the trial, favored phenylbutazone, but it did not reach a statistically significant level. The mean values of the endpoint parameters of spinal motion showed statistically significant improvement in both groups, except in the Schober test in the flurbiprofen group and chest expansion in the phenylbutazone group. Untoward effects characteristic of these drugs were found in a few patients.
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A double-blind parallel multi-centre study of 102 patients with rheumatoid arthritis (RA) was performed, comparing ibuprofen (1200-2400 mg daily) and ketoprofen (150-300 mg daily) a new non-steroidal, anti-inflammatory agent, over a three month period. Ketoprofen was well tolerated and shown to have comparable efficacy with ibuprofen. Longterm efficacy and tolerance studies are indicated.
Thirty-six women from a Northwest Indian population known to have an increased prevalence of rheumatoid arthritis were studied. The course of the clinical disease was that of erosive rheumatoid arthritis with characteristic involvement of metacarpophalangeal and wrist joints. Rheumatoid factor and antinuclear antibody tests were frequently positive, and reactions to gold therapy were more frequent than in other rheumatoid populations. Viral antibodies were similar in the rheumatoid and the control groups. HL-A W24 and HL-A BW40 were increased in both the diseased and the control Indian populations.
The effectiveness of naproxen in the management of acute gouty arthritis was assessed in an open study of 20 patients. These patients were selected on the basis of their clinical presentation of characteristic acute arthritis associated in 19 with concomitant hyperuricemia. There were 17 men and three women varying in age from 35 to 89 years. The first 12 patients were treated with 600 mg naproxen initially, followed by 300 mg every 8 hours for the first 48 hours and then tapered or discontinued depending upon their clinical response. The last eight patients received a loading dose of 750 mg naproxen, followed by 250 mg every 8 hours for a duration of 72 hours before tapering the drug. The response of 15 of the 20 was either excellent or good, while the response was fair in three and poor in two. Poor responders had been failures in other regimens or were treated late in the course of their attack. The higher loading dose was associated with more rapid and satisfactory remission. No significant undesirable side effects were observed. On the basis of this study, naproxen was found effective in alleviating the inflammation of acute gout.
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Thirty-six patients with rheumatoid arthritis were studied to determine the effectiveness and safety of combined therapy with naproxen and aspirin. An 8-week double-blind crossover trial was performed in which naproxen and placebo were administered on a background of constant-dose aspirin. Combination therapy was demonstrated to be more effective than aspirin alone. Tolerance of the two regimens was comparable.
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