Tolfenamic acid: clinical experience in rheumatic diseases

Area of Science:

• Pharmacology
• Rheumatology
• Drug Efficacy Studies

Background:

• Tolfenamic acid (TA) inhibits leukotriene synthesis, potentially offering an alternative to prostaglandin-inhibiting NSAIDs for rheumatic diseases.
• Previous studies since the 1970s have evaluated the clinical efficacy and side effects of TA in approximately 900 patients with rheumatic conditions.

Purpose of the Study:

• To assess the clinical efficacy and side effect profile of Tolfenamic acid (TA) in comparison to other nonsteroidal anti-inflammatory drugs (NSAIDs) for rheumatic diseases.
• To evaluate the analgesic effects of TA relative to nine other NSAIDs in patients with rheumatoid arthritis.

Main Methods:

• Conducted double-blind trials comparing TA efficacy against control drugs.
• Performed a single-blind study ranking the analgesic effect of ten NSAIDs, including TA, based on patient preference.
• Analyzed upper gastrointestinal side effects and other adverse events like dysuria from TA treatment.

Main Results:

• TA demonstrated clinical efficacy comparable to control drugs in double-blind trials.
• In patient-ranked analgesic comparisons, TA ranked among the top four drugs, alongside naproxen, indomethacin, and diclofenac.
• TA treatment resulted in less than half the number of upper gastrointestinal side effects compared to control NSAIDs, though dysuria was observed exclusively with TA.

Conclusions:

• Tolfenamic acid (TA) is a clinically effective NSAID for rheumatic diseases with a potentially improved gastrointestinal safety profile.
• TA exhibits comparable analgesic efficacy to other leading NSAIDs, making it a valuable therapeutic option.
• While TA offers gastrointestinal benefits, clinicians should be aware of the potential for dysuria as a specific side effect.