Effects of antirheumatic treatment on gastric secretory function and salivary flow in patients with rheumatoid arthritis.

Many patients with rheumatoid arthritis have impaired gastric acid secretion and dysfunction of the lacrimal and salivary glands, conditions which have been proposed to be due to glandular atrophy. The hypothesis that the rheumatoid inflammation by itself has a depressive effect on these secretory functions was tested on 20 patients with active rheumatoid arthritis who underwent 16 weeks of sulphasalazine therapy. The patients responded well to the treatment, with reduction of joint indices and acute phase reactants. The resting and stimulated whole salivary secretion rate increased in 9/10 and 8/10 patients, respectively. The maximal gastric acid output increased in those patients who had a moderate reduction in acid output prior to treatment. When estimated by s-pepsinogen I, the gastric secretory capacity increased in all patients but one. In a group of auranofin treated patients, s-pepsinogen I rose only in those who responded to treatment with reduced disease activity. These results support the idea that the impaired secretory functions are at least partially reversible and probably also partly inflammatory mediated.