DOSAGE OF SALICYLATES FOR CHILDREN WITH JUVENILE RHEUMATOID ARTHRITIS A Prospective Clinical Trial with Three Different Preparations of Acetylsalicylic Acid

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Abstract
Children with juvenile rheumatoid arthritis (JRA) (41) and 6 with postinfectious arthropathies 3-15 yr old were treated with acetylsalicylic acid for 14 days during which the patients were hospitalized. Different acetylsalicylic acid preparations (3) were used: a microencapsulated form, an enteric-coated form and standard acetylsalicylic acid tablets. Serum salicylate concentrations were measured by Trinder''s photometric method. With doses of 90-120 mg/kg per day symptoms of salicylism appeared in about 50% of the cases. Daily doses of 2 g/m2 (not exceeding 70 mg/kg) proved relatively safe in this study; symptoms and signs of intoxication appeared at doses exceeding 3 g/m2 per day. In this respect there were no significant differences between the 3 acetylsalicylic acid preparations used. Apparently serum salicylate concentrations should not exceed 2000 .mu.mol/l (about 27 mg/100 ml). The symptoms of salicylism correlated closely with serum salicylate levels which correlated well with the dosage in g/m2. Elevation of serum aspartate aminotransferase was noted in 1/3 of the cases. All of these had a dose exceeding 2 g/m2 and the frequency of elevated enzyme activities increased with increasing dosage. In the group receiving enteric-coated form of acetylsalicylic acid there were fewer positive benzidine tests (12%) than in the 2 other groups (22-28%).