sommers@topaz.RUTGERS.EDU (Mamaliz @ The Soup Kitchen) (08/16/85)
I am now being started on my 3rd anti-inflammatory in less then a year. I
have had non-fun reactions to the other 2 (indocin and clinoril). My
questions are:
1) Is there any evidence that anti-inflammatories really help arthritis?
2) What causes the bad reactions (nothing terrible, just feeling awful)?
3) What side-effects do these drugs usually have?
I have not been on all of these for the arthritis (the indocin was
prescribed for a different problem) but 2 doctors have now prescribed them
for arthritis and related knee problems.
liz
--
liz sommers
My "best address" will soon be changing to
topaz!mama!liz
but I can still be reached at:
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arpa: sommers@rutgerssdyer@bbncc5.UUCP (Steve Dyer) (08/16/85)
> 1) Is there any evidence that anti-inflammatories really help arthritis? It is generally agree upon that the anti-inflammatory drugs (aspirin, ibuprofen, indomethacin, etc.) provide varying degrees of symptomatic relief of arthritis, but do not influence the underlying condition. > 2) What causes the bad reactions (nothing terrible, just feeling awful)? The two drugs you have mentioned, indomethacin and sulindac, are among the least well-tolerated of the anti-inflammatory drugs. They are also two of the most powerful. You haven't been particularly descriptive of your side effects, but both have been known to affect mood and cause headache in certain patients. It's fair to say that the mechanism of many of these side-effects hasn't been elucidated, though its a fair bet that the same mechanisms responsible for their therapeutic actions (inhibition of prostaglandin synthesis) may also contribute to the side effects. > 3) What side-effects do these drugs usually have? Up to 50% of patients treated with indomethacin, and 25% of those treated with sulindac report some kind of side-effect. Speaking VERY GENERALLY, the second class of drugs (ibuprofen, other fenamates, tolmetin, aspirin) are somewhat better tolerated. It's a clinical call for the doctor to decide exactly which one to prescribe, when to use the "big guns", and personal clinical experience probably goes a long way. You should speak up if the prescribed therapy doesn't agree with you. Individual idiosyncracy seems to be the rule with this class of drugs. The one side-effect that they all have in common is stomach upset. Much is made of the fact that one drug causes less of this than another, but given the right person with the right history and enough drug, you can probably expect some kind of gastrointestinal side-effects ranging from heartburn to ulcers. Many of these (not all) are also associated with increased gastric bleeding. Many of these also cause some degree of CNS effects in sensitive patients, such as headache, dizziness, light-headedness and other reactions. If you look into the literature, there are many other reported side-effects, but they are so varied, and so idiosyncratic that they're not worth excessive worrying about beforehand. -- /Steve Dyer {decvax,linus,ima,ihnp4}!bbncca!sdyer sdyer@bbnccv.ARPA
geb@cadre.ARPA (Gordon E. Banks) (08/16/85)
I am not sure that there is any hard evidence that anti-inflammatory drugs provide more than symptomatic relief (perhaps Craig will be kind enough to do a search), but since inflammation is thought to be a factor in the process of deposition of calcium leading to osteophytes, it would stand to reason that controlling the inflammation may have long term beneficial effects in preventing disability. Proof would require long-term longitudinal studies, and thus might not have been done yet.