Osteoarthritis and non-steroidal and anti-inflammatory drugs: a multi-centre comparative study

An open, multi-centre study was carried out in 239 elderly out-patients referred with symptomatic osteoarthritis of the hip and/or knee to assess the effectiveness of 200 mg sulindac twice daily compared with either 400 mg ibuprofen 3-times daily, 250 mg naproxen twice daily or 25 mg diclofenac 3-times daily. Assessments were made before and during the 12-week trial period of disease activity, weight-bearing pain, pain on active and passive movement, night pain, and inactivity stiffness. The results showed that there was significant improvement in all of the parameters with each of the treatments, and the difference between treatments was significant in favour of sulindac compared with ibuprofen in disease activity, weight-bearing pain and pain on active movement. In the overall assessment of response to treatment at the end of the trial it was the patients' opinion that the degree of improvement was better on sulindac than on the comparative drugs. The main side-effect leading to some patients withdrawing from the trial was abdominal pain.