Enteric-coated aspirin in rheumatoid arthritis

5-Aminosalicylic acid or sulphapyridine. Which is the active moiety of sulphasalazine in rheumatoid arthritis?

Thirty patients with active rheumatoid arthritis participated in an open study of 6 months' treatment with either 5-aminosalicylic acid or sulphapyridine, the two moieties of sulphasalazine. Patients were assessed at regular intervals using a number of clinical and biochemical tests designed to detect specific antirheumatic activity. Patients taking sulphasalazine showed significant improvement in most parameters of disease activity, but those taking 5-aminosalicylic acid did not improve despite the fact that high serum concentrations of 5-aminosalicylic acid and acetyl 5-aminosalicylic acid were achieved. These results suggest that sulphapyridine is the active moiety of sulphasalazine. Its possible mode of action is discussed. Nausea was a frequent problem in patients taking sulphapyridine. Unless this problem can be overcome, sulphapyridine is unlikely to offer any therapeutic advantages over sulphasalazine in the treatment of rheumatoid arthritis.

A comparison of therapies which may influence trace metals in rheumatoid arthritis

Forty-five patients with active rheumatoid arthritis (RA) were treated with D-Penicillamine (DPA), zinc sulphate or trien for 24 weeks. Clinical and biochemical assessments were made on eight occasions during the treatment period. Results supported the view that DPA is efficacious causing both clinical and biochemical improvement, whereas zinc sulphate provided clinical benefit in some patients without improving the biochemistry, and trien was ineffective in both respects. The results indicate the need for more thorough investigations of the effect of drugs on trace metal distribution in RA.

Comparison of three slow-release acetylsalicylic acid preparations in rheumatoid arthritis

Nine patients suffering from chronic rheumatoid arthritis were each given single doses of 1 g acetylsalicylic acid, in the form of each of the preparations studied: an enteric-coated tablet, a microcrystalline tablet, and a capsule containing enterosoluble granules. Absorption from each preparation was good in all patients. Onset of absorption varied to some degree, but similar salicylate levels were reached within 5 hours with all preparations. In the case of enteric-coated tablets, relatively high salicylate levels persisted 12 hours after dosing, which would seem to permit twice daily dosage, regardless of the total daily dose.