A double-blind trial was carried out in 76 patients with active
rheumatoid arthritis to compare the
analgesic and anti-inflammatory activity of 3 g.
alclofenac with 4.8 g.
aspirin daily over a 6-week period. All patients selected showed reversible inflammatory swelling of the finger joints. Of the 60 patients successfully completing the trial, 30 were treated as out-patients and 30 patients received in-patient treatment for approximately the first 2 weeks. Both groups were analysed separately. Treatment was randomised and patients received the drugs in identical
tablet form except for the last 16 patients who were transferred to capsules. Results showed that though the activity potential, morning stiffness, grip strength,
joint pain and tenderness improved significantly at the end of the 6-week period, there was no statistical difference between the two drugs. However, functional capacity indicated slight superiority of
alclofenac over
aspirin at a low level of significance. P.I.P. joint swelling showed that both in-patients and out-patients on
alclofenac improved significantly (p less than .001)compared to patients in the
aspirin group. Laboratory investigations showed no difference between the two drugs as far as changes in
serum proteins, serum
transaminase, haemoglobin and E.S.R. levels were concerned. However, serum
uric acid levels dropped significantly (.05 greater than p greater than .01) with
aspirin. The incidence of side-effects was slightly higher in the
aspirin group but a high incidence of
skin rash (30% approx.) was recorded with
alclofenac tablets. No incidence of
skin rash was recorded in patients taking
alclofenac capsules, but the number of patients taking capsules was too small to make any prediction. It appears from this study that in active
rheumatoid arthritis the
analgesic and anti-inflammatory activity of 3 g.
alclofenac is equivalent to 4.8 g.
aspirin, and
alclofenac is superior to
aspirin in reducing the inflammatory swelling of rheumatoid joints.