Clinical trial of tolmetin and aspirin in the treatment of rheumatoid arthritis.

A double-blind crossover, within-patient trial was conducted, to compare the efficacy of tolmetin (Tolectin; Ethnor) with that of aspirin in the treatment of rheumatoid arthritis. Tolmetin significantly improved morning stiffness (P less than 0.01), while aspirin was superior in reducing the number of painful joints (P less than 0.001) and the articular index (P less than 0.01). Tolmetin, in marked contrast to aspirin, was well tolerated, producing virtually no side-effects. An elevation of the alkaline phosphatase was noted in 4 patients on tolmetin therapy. When used after aspirin, tolmetin had a significantly adverse effect on the erythrocyte sedimentation rate (P less than 0.05). The results of this study indicate that tolmetin is a useful addition to the therapeutic agents for the treatment of rheumatoid arthritis, because of its ability to reduce morning stiffness and its lack of side-effects.