High-dose aspirin has long been considered first-choice therapy for the treatment of rheumatoid arthritis and other inflammatory rheumatic diseases.1 Recently some clinicians have challenged this premise and suggested that the newer nonsteroidal anti-inflammatory agents, while more costly, are equally efficacious and less toxic.2 They have emphasized less gastrointestinal toxic reaction and have suggested that these drugs be substituted for aspirin as a foundation of medical therapy. We have disagreed, noting the relatively short experience with the newer agents, as well as the emergence of a number of side effects with their continued use.3 The subject of renal toxic reaction of aspirin and other nonsteroidal agents has been discussed in the literature. The article by Emkey and Mills in this issue of The Journal (p 55) examines the safety of long-term ingestion of large cumulative doses of aspirin from the standpoint of significant renal parenchymal disease.
Gall EP. The Safety of Treating Rheumatoid Arthritis With Aspirin. JAMA. 1982;247(1):63–64. doi:10.1001/jama.1982.03320260047031
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