Steroid-sparing action of flurbiprofen: use of an additional parameter of joint scans with 99m technetium

A double-blind placebo controlled trial was carried out in 14 steroid-dependent patients with rheumatoid arthritis to assess the effectiveness and steroid-sparing action of flurbiprofen over a 4-week period. During the first week, the patients' steroid dosage was stabilized at the minimum necessary to control symptoms. They were then treated with either 100 mg flurbiprofen or placebo 3-times daily for 3 weeks. Steroid dosage was initially reduced to 50% of the stabilized dose and reduced further if practicable, depending on therapeutic response. Clinical assessments were made, at weekly intervals, of pain, swelling, tenderness, erythema, range of movement, grip strength, walking time, and duration of morning stiffness. Joint scanning of 99mTc uptake was also measured before and after treatment in 11 patients. The results showed that whereas 3 out of 6 patients on placebo has distinct inflammatory flare-up, this did not occur in any of the 8 patients on flurbiprofen. Moreover, 3 of the flurbiprofen group showed improvement and a further reduction in steriod dosage was possible in 3 patients. Improvements in joint scans correlated well with the clinical findings in 6 of 11 patients.