sulindac and Arthritis--Juvenile

Sulindac (Clinoril; Frosst-MSD), a non-steroidal anti-inflammatory drug was compared with aspirin in a randomized double-blind cross-over controlled study in 30 patients with juvenile chronic arthritis. Sulindac was found to be safe and effective. Although it has the advantage of a twice-a-day dose regimen, both patient and doctor may prefer to be guided by pain relief and cost.

Topics: Adolescent; Adult; Arthritis, Juvenile; Aspirin; Child; Child, Preschool; Chronic Disease; Clinical Trials as Topic; Double-Blind Method; Drug Evaluation; Female; Humans; Indenes; Male; Random Allocation; Sulindac

Topics: Acute Disease; Adult; Arthritis, Juvenile; Female; Humans; Indenes; Pancreatitis; Sulindac

Salicylate is the drug of first choice in the initial treatment of juvenile rheumatoid arthritis. In therapeutic dosage it will adequately control joint symptoms in the majority of patients. For children who do not respond to or are intolerant of salicylate, a change to one of the other nonsteroidal anti-inflammatory agents is appropriate. In progressive polyarthritis unresponsive to the above agents, the addition of gold, antimalarials, or penicillamine is indicated, preferably in that order. Corticosteroid therapy should be reserved for selected patients meeting specific criteria. Pharmacotherapy of juvenile rheumatoid arthritis should always be individualized. For optimal treatment of the whole child it must be combined with both physical and educational measures.

Topics: Adrenal Cortex Hormones; Antimalarials; Arthritis, Juvenile; Chemical and Drug Induced Liver Injury; Child; Delayed-Action Preparations; Gold; Humans; Ibuprofen; Indomethacin; Penicillamine; Salicylates; Sulindac; Tolmetin

This communication describes the first known report of sulindac-induced anaphylaxis. A 17-year-old patient who ingested a single tablet of sulindac developed pruritus, hives, and dyspnea. Blood pressure was not detectable. The patient was treated with epinephrine, a corticosteroid, and an antihistamine. Recovery was complete. The ability of this class of drugs to produce dangerous reactions is discussed.

Topics: Adult; Anaphylaxis; Arthritis, Juvenile; Drug Hypersensitivity; Female; Humans; Indenes; Sulindac

Topics: Adolescent; Arthritis, Juvenile; Chemical and Drug Induced Liver Injury; Female; Humans; Indenes; Sulindac