A double-blind crossover comparison of tolmetin sodium and phenylbutazone in the treatment of rheumatoid arthritis.

A double-blind crossover study was carried out in 24 patients with rheumatoid arthritis to investigate the relative efficacy of tolmetin (1600 mg/day) and phenylbutazone (400 mg/day). Each drug was given for 4 weeks, preceded by a 2-week wash-out period during which patients received paracetamol alone for pain relief. Assessments were made of duration of morning stiffiness, grip strength, articular index, joint size, and degree of pain. Both drugs produced significant improvements compared to paracetamol, particularly in pain relief and, apart from morning stiffness, tolmetin proved equally effective as phenylbutazone. Three patients (2 on tolmetin and 1 on phenylbutazone) were withdrawn because of side-effects. In general, however, both drugs gave rise to only minor side-effects.