QUANTITATIVE ASSESSMENT OF JOINT PAIN FOLLOWING TREATMENT OF RHEUMATOID-ARTHRITIS WITH IBUPROFEN CREAM

The antiinflammatory effect of percutaneous application of NSAID (DOLGIT(R) cream) was evaluated quantitatively on 11 patients with symmetric rheumatoid arthritis of the metacarpophalangeal and/or proximal interphalangeal joints. The pressure pain detection threshold (PDT) and pressure pain tolerance threshold (PTT) on the test joints were measured before and on days 3 and 7 after double-blind placebo controlled application of NSAID cream. The clinical pain was assessed by a visual analog scale (VAS) following controlled finger movements. The relative median PDT differences between NSAID and placebo treatment median were 10 kPa (N.S.) on day 3 and 17 kPa (N.S.) on day 7. The corresponding median differences in PTT were -5 kPa (N.S.) and 23 kPa (P < 0.05), respectively. The corresponding median decreases in VAS score were 4.2 mm (N.S.) and 15.5 mm (N.S.), respectively. The experimental joint pressure techniques can assess selectively pain from small joints and is a new useful tool to evaluate antinociceptive and/or antiinflammatory effects.