Tolmetin and salicylate therapy in acute rheumatic fever Comparison of clinical efficacy and side effects
Pediatrics International (2003) 45 , 676–679. Background : The arthritis of rheumatic fever is very responsive to treatment with salicylates, but there aremany adverse reactions, especially hepatotoxicity, due to aspirin (acetylsalicylic acid) therapy. These side-effects change the course and durati...
| Main Authors: | , , , , , |
|---|---|
| Other Authors: | , , |
| Format: | Article in Journal/Newspaper |
| Language: | English |
| Published: |
Pediatrics International
2003
|
| Subjects: | |
| Online Access: | http://hdl.handle.net/11616/8028 http://onlinelibrary.wiley.com/doi/10.1111/j.1442-200X.2003.01801.x/epdf |
| Summary: | Pediatrics International (2003) 45 , 676–679. Background : The arthritis of rheumatic fever is very responsive to treatment with salicylates, but there aremany adverse reactions, especially hepatotoxicity, due to aspirin (acetylsalicylic acid) therapy. These side-effects change the course and duration of rheumatic fever. Other non-steroidal anti-inflammatory drugs maybe equally effective, although no reports are available. Methods : We studied 72 patients with rheumatic fever who were admitted to Dr Sami Ulus Children’s Hospitalbetween 1995 and 1999. Twenty patients with arthritis were treated with tolmetin (25 mg/kg per day; group I)and 52 patients with arthritis and/or mild carditis were put on aspirin therapy (75–100 mg/kg per day) for 4–6weeks (group II). Arthritis had disappeared at the same time in both the aspirin and tolmetin groups (P = 0.675). Results : The erythrocyte sedimentation rates of patients upon admission, at the first week and at the end oftherapy were not different in the two groups (P > 0.05). No adverse effect of tolmetin therapy was observed,whereas side-effects of salicylate were observed in 19 patients (36.5%) in the aspirin group. Hepatotoxicity,gastric irritation and salicylism were found in 16, four and three patients, respectively. Renal toxicity andReye syndrome were not demonstrated. Because of these side-effects of aspirin, therapy had to be stopped for10–20 days and the duration of hospitalization in this group was lengthened unnecessarily. Conclusion : Tolmetin was safe and effective treatment for arthritic rheumatic fever patients without carditis.Tolmetin can be used particularly in patients who cannot tolerate aspirin. |
|---|