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October 1, 1982

Trolamine Salicylate Cream in Osteoarthritis

JAMA. 1982;248(13):1577. doi:10.1001/jama.1982.03330130025009

To the Editor.—  The recent report by Algozzine et al, "Trolamine Salicylate Cream in Osteoarthritis of the Knee" (1982;247:1311), raises two issues, one involving the design of the trial reported and the other involving the possible role of nonperoral medications in the treatment of arthritis.Several features of Algozzine and colleagues' trial design virtually guaranteed that the topical salicylate being tested would appear to be largely ineffective. Most important, while the preparation studied is indicated for the treatment of minor aches and pains associated with arthritis and rheumatism, more than half of Algozzine's patients had fairly severe or very severe osteoarthritis: 13 of the 25 patients were in American Rheumatism Association (ARA) functional class III ("limited only to little or none of duties in usual occupation or self care"); 14 of the 25 had advanced disease (stage 3 or 4) by radiological standards, involving major loss of cartilage in the