Aspirin in the Treatment of Chronic Inflammatory Arthritis

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Abstract
This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. To the Editor.— Pharmaceutical firms have expended enormous resources to develop and promote the use of nonsteroidal anti-inflammatory drugs (NSAIDs), chiefly for treatment of various rheumatic diseases. Some of these agents have become widely used as substitutes for aspirin. Controlled clinical trials of these agents, almost always against fixed daily doses of plain aspirin, have usually shown "equivalent" anti-inflammatory effects with less toxicity. Unfortunately, these fixed daily doses almost certainly produced serum salicylate levels that were subtherapeutic, ie, less than 20 mg/dL (1.45 mmol/L). This is especially true in trials involving patients with serious chronic inflammatory conditions such as rheumatoid arthritis. In our experience, none of the NSAIDs have been as reliable as the use of aspirin in doses individually prescribed to produce stable serum salicylate levels of 20 to 30 mg/dL (1.45 to 2.15 mmol/L). Aspirin remains our first choice in the treatment of diseases such as rheumatoid arthritis,

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