Continued use of non‐steroidal anti‐inflammatory drugs: an index of clinical efficacy.

1 A double-blind entry to a trial of an active non-steroidal anti-inflammatory drug, flurbiprofen against placebo was undertaken until 100 patients with classical rheumatoid arthritis had been allocated to each treatment. 2 Each patient was given a long-term supply of drug and was asked to vary their own dosage within simple limits, according to the severity of their symptoms. They were instructed to return immediately they felt dissatisfied with their medication either on account of side-effect or of lack of effect. 3 The length of time that patients remained satisfied with their drug was used as the sole measure of efficacy of the drug. At 2 weeks there were only 30% remaining on placebo and by 4 months no patients remained satisfied with the inactive drug. Forty-three per cent were satisfied with flurbiprofen at the end of 1 year. 4 Clearly compliance with anti-rheumatic drugs is better if the drugs are effective and there is no long-term placebo response in rheumatoid arthritis.