salicylates and Osteoarthritis--Hip

To assess the efficacy and safety of a copper-salicylate gel in osteoarthritis of the hip and knee.. Randomised, double-blind, placebo-controlled study.. Rheumatology Clinic of St Vincent's Hospital, Sydney, New South Wales (a tertiary referral hospital), June 1993 to October 1994.. 116 patients with pain associated with osteoarthritis of the hip and/or knee (diagnosed by criteria of the European League against Rheumatism), drawn from patients attending the Clinic or self-referred after newspaper advertisements.. Copper-salicylate or placebo gel (1.5 g) applied twice daily to the forearm for four weeks.. Self-assessment of pain before the trial and after two and four weeks of treatment; patient and investigator assessments of efficacy; additional analgesia required; adverse reactions; and withdrawal rates.. Pain scores at rest and on movement decreased in both the copper-salicylate and placebo groups by 13%-20%. There was no significant difference between the two groups for decrease in pain score, patient and investigator efficacy ratings, number of patients requiring paracetamol for extra analgesia (active, 77%; placebo, 71%) and average dose of paracetamol (active, 555 mg/day; placebo, 600 mg/day). Significantly more patients in the copper-salicylate group reported adverse reactions (83% versus 52% of the placebo group), most commonly skin reactions, and withdrew from the trial because of these reactions (17% versus 1.7% of the placebo group).. Copper-salicylate gel applied to the forearm was no better than placebo gel as pain relief for patients with osteoarthritis of the hip or knee, but produced significantly more skin rashes.

Topics: Administration, Cutaneous; Adult; Aged; Aged, 80 and over; Anti-Inflammatory Agents, Non-Steroidal; Copper; Double-Blind Method; Female; Gels; Humans; Knee Joint; Male; Middle Aged; Organometallic Compounds; Osteoarthritis; Osteoarthritis, Hip; Pain Measurement; Salicylates

Imidazole salicylate (750 mg t.i.d.) was compared with ibuprofen (400 mg t.i.d.) in a 60-day double-blind parallel group clinical trial in 31 patients with osteoarthritis. Both drugs were effective in relieving joint pain and in reducing the duration of morning stiffness. A statistically significant reduction of the severity of these symptoms was observed already one week after the start of treatment, lasting until the end of the study. No significant differences in efficacy were demonstrated between the two drugs throughout the trial. The systemic tolerability, assessed by changes in tests of hematological, liver and kidney function, urinalysis and faecal occult blood was excellent with both treatments. The incidence of side effects (mostly gastrointestinal complaints) was fairly low in both groups, and less severe in the group treated with imidazole salicylate.

Topics: Adult; Aged; Double-Blind Method; Female; Humans; Ibuprofen; Imidazoles; Knee Joint; Male; Middle Aged; Osteoarthritis; Osteoarthritis, Hip; Salicylates

Topics: Administration, Cutaneous; Analgesics; Copper; Gels; Hip Joint; Humans; Knee Joint; Osteoarthritis; Osteoarthritis, Hip; Pain; Salicylates

The effects of several nonsteroidal antiinflammatory drugs, used at concentrations achievable in synovial fluid, on human osteoarthritic (OA) cartilage metallo-protease activity in vitro was studied. Acetaminophen and ketoprofen had no effect; sodium salicylate, indomethacin, and diclofenac slightly decreased proteoglycanase activity. Piroxicam and tenoxicam suppressed proteoglycanase activity by 48.2% and 68.3%, respectively, and suppressed collagenase activity by 19.1% and 36.8%, respectively. Use of these NSAIDs may help to decrease cartilage catabolism in patients with OA.

Topics: Acetaminophen; Aged; Anti-Inflammatory Agents, Non-Steroidal; Cartilage, Articular; Diclofenac; Endopeptidases; Female; Humans; Indomethacin; Ketoprofen; Male; Metalloendopeptidases; Microbial Collagenase; Middle Aged; Osteoarthritis, Hip; Piroxicam; Salicylates; Salicylic Acid

Predispositions to prescribe a pure analgesic, a cyclooxygenase inhibiting nonsteroidal antiinflammatory drug (NSAID) or a nonacetylated salicylate for a fictitious, uncomplicated case of osteoarthritis (OA) were surveyed in a sample of 152 community based primary care practitioners who had been characterized with respect to medical education and practice characteristics. Only 2 respondents (1%) prescribed a pure analgesic; 35% prescribed subantiinflammatory doses of cyclooxygenase inhibiting NSAID. The remainder (64%) recommended nonacetylated salicylates and cyclooxygenase inhibiting NSAID in doses large enough to achieve an antiinflammatory effect. Past participants in postgraduate rheumatology electives prescribed more costly regimens than those who had not participated (p = 0.05). When the case was altered to include a history of previous peptic ulcer, 44% chose cyclooxygenase inhibiting NSAID with adjunctive prophylaxis against NSAID induced gastropathy (e.g., misoprostol). When the complication was changed to renal insufficiency, recommendations for sulindac increased 3-fold over those for the uncomplicated case (34 vs 11%), and were most common among more recent medical school graduates and past participants in rheumatology electives (p less than 0.05 for both). The potential effects of educational and practice variables on the therapeutic strategies and costs of OA care in the community merit further systematic study.

Topics: Aged; Anti-Inflammatory Agents, Non-Steroidal; Education, Medical; Humans; Male; Osteoarthritis, Hip; Physicians, Family; Practice Patterns, Physicians'; Salicylates