The in vivo effect of nonsteroidal anti-inflammatory drugs, gold sodium thiomalate and methotrexate on neutrophil superoxide radical generation.

The generation of superoxide radicals by activated peripheral blood polymorphonuclear leukocytes from patients with rheumatoid arthritis (RA) has been measured and the in vivo effect of nonsteroidal anti-inflammatory drugs (NSAIDs) and disease remittive agents studied. Generation of superoxide radicals from RA patients was significantly decreased when compared to a control population. This was principally due to the disease rather than medications in that patients with osteoarthritis receiving NSAID generated superoxide radicals similar to that seen in the control group. RA patients receiving NSAIDs and injectable gold or methotrexate therapy showed a significant trend to normalization of superoxide radical generation when compared to those with RA receiving NSAIDs alone. We conclude that the reduced generation of superoxide radicals on activated polymorphonuclear leukocytes from patients with RA is principally a feature of the disease and that this abnormality can be partially reversed by the use of a disease remittive agent in vivo.