Butazolidin suppository medication in rheumatism; a clinical study in general practice

One hundred and seventeen patients with various rheumatic conditions were admitted by eighteen general practitions to a multicentre open clinical trial of the acceptability, effectiveness and tolerability of Butazolidin Suppositories. Dosage was one or two suppositories (= 250 mg or 500 mg phenylbutazone) per day for up to eight weeks. Of the 117 patients entered onto the register for the study, 10 patients refused suppository medication and 8 had local conditions contra-indicating their use. Of the 99 patients starting the trial proper, half had excellent symptomatic relief and tolerance. Sixteen patients discontinued because of poor response. The remainder (34) whilst having significant improvement as shown by mean symptom scores, discontinued treatment. The majority who discontinued did so because of minor local discomfort or minor gastric symptoms, suggesting that acceptability of medication was at least as important as intolerance. No patient had a serious or persistent adverse effect. Comparison with previous studies suggests that gastro-intestinal tolerance to phenylbutazone is improved when it is administered by suppository.