We are pleased that our study has promoted interest and controversy. Dr O'Brien is correct in urging further development of safe and effective nonperoral medications for rheumatic disorders. However, some of the points that he has raised need clarification.First, it was never our intent to denigrate the use of topical agents in treating rheumatic disorders. In fact, a recent report has shown efficacy and systemic absorption of trolamine salicylate cream in patients with rheumatoid arthritis treated with one application, in an open-labeled study.1For our double-blind controlled study, we realized that the difficulties were formidable in selecting a defined patient group with specific chronic pain disorders of soft tissue that would potentially respond to an agent like trolamine salicylate cream. Hence, we selected patients with osteoarthritis because of the ease of categorizing such a disorder. Although it is true that a significant percentage of our patients
Algozzine GJ, Stein GH. Trolamine Salicylate Cream in Osteoarthritis-Reply. JAMA. 1982;248(13):1577–1578. doi:10.1001/jama.1982.03330130025010
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