Clinical response to non-steroidal anti-inflammatory drugs in urate-crystal induced XXXX : a simultaneous study of intersubject and intrasubject variability.

@entity1 @entity32 @entity85 @entity5018
1. It is well known that an individual subject often responds preferentially to a particular nonsteroidal anti-inflammatory drug (NSAID) and clinical response to these drugs is characterised by considerable variability between individuals. Variability in response has often been attributed to the episodic nature of @entity85 . Few studies have studied intrasubject variability in response to these drugs using a multiple crossover design. A major difficulty has been the lack of objective, validated measures of @entity32 sensitive to NSAIDs. The primary aim of the present study was to test the utility of urate-crystal induced @entity32 as a tool to predict NSAID response in @entity1 . 2. An inflammatory reaction was established in twenty-five healthy subjects with intradermal injection of urate crystals on four separate occasions separated by 1 week. Each subject was randomly assigned to receive either @entity5018 on two of these occasions (800 mg four times over 36 h) or matched placebo on the other two occasions using a double-blind, cross-over design. Decrease in the area under the wheal size-time curve was used to indicate anti-inflammatory response. 3. Peak inflammatory response was observed at about 32 h and had dissipated by 56 h post-urate injection. The logarithmic mean wheal area was significantly lower after @entity5018 (mean +/- s.e. mean; 6.74 +/- 0.09) compared with placebo (6.96 +/- 0.07 mm h); a difference of 20% (95% confidence interval for difference: 1 to 35%; P < 0.05). 4. There was marked intra- and intersubject variability in response to @entity5018 over the four treatment periods.(ABSTRACT TRUNCATED AT 250 WORDS)
