An open assessment of the efficacy and tolerability of diclofenac sodium (Voltarol) in patients with rheumatic disease and a comparative study of diclofenac sodium (Voltarol) with indomethacin in patients with osteoarthritis and rheumatoid arthritis.

The efficacy and tolerability of diclofenac was studied in an initial two-week assessment study in 24 patients with rheumatic disease. During the first week patients received 1 x 25 mg diclofenac t.d.s., with subsequent dosage adjustments according to response. Most completers showed improvement in joint pain and functional grade, and patients' rating of their condition indicated a significant improvement. Nine patients were withdrawn because of poor symptom control or side-effects, and there were a number of other minor side-effects not necessitating withdrawal. However, there were no persistent or lasting side-effects, and laboratory tests revealed no significant abnormalities. In a two-week double-blind study, diclofenac was compared with indomethacin in 43 outpatients with osteoarthritis or rheumatoid arthritis. Dosage in the first week was 1 x 25 mg tablet of either diclofenac or indomethacin (random allocation) t.d.s., with further adjustments as necessary. There were no significant differences in the effectiveness of the two drugs, and no differences in dosage requirements. Three patients were withdrawn from each treatment group. Gastrointestinal side-effects predominated in the diclofenac-treated group, with central nervous system unwanted effects more frequent in the indomethacin group.