The influence of alclofenac treatment on acute-phase proteins, plasma tryptophan, and erythrocyte sedimentation rate in patients with rheumatoid arthritis.
Alclofenac and D-penicillamine were compared under controlled, double-blind conditions in the treatment of 35 patients with active rheumatoid arthritis over a period of 26 weeks. The principal aim of the study was to investigate any relationships between changes in clinical status and changes in concentrations of three serum acute-phase proteins (fibrinogen, C-reactive protein, and haptoglobin), plasma free and protein-bound L-tryptophan, and the erythrocyte sedimentation rate. Both alclofenac and D-penicillamine were clearly effective: all patients showed steady improvement on the seven clinical indices of response employed. Drug management was easiest with alclofenac. Both drugs produced a significant reduction in acute-phase proteins, E.S.R. and protein-bound plasma tryptophan. Since it has previously been established that the course of rheumatoid arthritis is reflected in the acute-phase protein levels and the extent to which L-tryptophan is bound to plasma protein, it is suggested that drugs, such as D-penicillamin and alclofenac which profoundly affect these parameters, provide not only symptomatic relief but also possible beneficial effects on the disease process itself.
D001172:Arthritis, Rheumatoid / Q000097:blood* / Q000188:drug therapy; D001798:Blood Proteins / Q000032:analysis*; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000032:analysis; D002986:Clinical Trials as Topic; D005340:Fibrinogen / Q000032:analysis; D006242:Haptoglobins / Q000032:analysis; D006801:Humans; D008875:Middle Aged; D010396:Penicillamine / Q000627:therapeutic use / Q000633:toxicity; D010648:Phenylacetates / Q000627:therapeutic use* / Q000633:toxicity; D011507:Proteinuria / Q000139:chemically induced; D011537:Pruritus / Q000139:chemically induced; D012217:Rheumatoid Factor / Q000032:analysis; D013921:Thrombocytopenia / Q000139:chemically induced; D014364:Tryptophan / Q000097:blood*
D001798:Blood Proteins; D006242:Haptoglobins; D010648:Phenylacetates; D014364:Tryptophan; D005340:Fibrinogen; D002097:C-Reactive Protein; D012217:Rheumatoid Factor; D010396:Penicillamine