Long-term efficacy and safety of tolmetin sodium in treatment of geriatric patients with rheumatoid arthritis and osteoarthritis: a retrospective study.

: In order to evaluate the effectiveness and safety of tolmetin sodium in the treatment of both rheumatoid arthritis (RA) and osteoarthritis in geriatric patients, a retrospective study was made of patients 65 years and older who participated in long-term, controlled, double-blind and open trials during both the investigational period and since marketing of the drug. Standard entrance criteria, methods of evaluating disease activity, and statistical methods were used in the study of both arthritic diseases. A total of 847 geriatric patients were studied for periods of up to one year; 171 had RA, while 676 had osteoarthritis of large or small joints. Average daily dose of tolmetin sodium was 1141 mg for patients with RA and 953 mg for patients with osteoarthritis. The results of this retrospective study of both RA and osteoarthritis patients show that tolmetin was as effective in geriatric patients as in nongeriatric patients. Symptoms responded rapidly to treatment with tolmetin, and both the inflammatory symptoms of RA and the joint pain and functional parameters of osteoarthritis showed improvement that was both statistically and clinically significant throughout the major course of therapy. Tolmetin was also found to be safe and well tolerated by the elderly patient population. The major complaints were gastrointestinal, but serious or limiting side effects occurred in few patients. The dropout rates due to adverse effects during the entire year of therapy were 15.8 per cent in the RA population and 15.4 per cent in osteoarthritis patients. This retrospective evaluation of tolmetin therapy shows significant relief of the symptoms of both RA and osteoarthritis in a geriatric population and fails to reveal any unusual or serious conditions which would contraindicate its use in the elderly patient. Tolmetin, which is an antiinflammatory agent with a short half-life, can provide adequate, safe therapy in the geriatric population.