Naproxen: corticosteroid-sparing effect in rheumatoid arthritis

Area of Science:

• Rheumatology
• Pharmacology

Background:

• Adult rheumatoid arthritis (RA) management often involves corticosteroids and NSAIDs.
• Optimizing treatment to reduce corticosteroid dependence is a clinical goal.

Purpose of the Study:

• To evaluate the corticosteroid-sparing potential of naproxen in ambulatory patients with active rheumatoid arthritis.
• To assess the efficacy and safety of naproxen in reducing paramethasone acetate dosage.

Main Methods:

• Double-blind, placebo-controlled study involving ambulatory RA patients stabilized on paramethasone acetate.
• Naproxen (400 mg daily) or placebo was administered while gradually reducing corticosteroid dosage.
• Patients were monitored for disease activity and adverse events over an average of 14 weeks.

Main Results:

• Patients receiving naproxen showed a 57% average reduction in paramethasone acetate dosage compared to 21% in the placebo group.
• Naproxen demonstrated a significant corticosteroid-sparing effect.
• Adverse events were minimal, with one possible case of euphoria possibly related to naproxen.

Conclusions:

• Naproxen exhibits a significant corticosteroid-sparing effect in rheumatoid arthritis management.
• Naproxen offers a viable option for reducing corticosteroid reliance in RA patients.
• The drug demonstrated negligible toxicity, supporting its potential therapeutic role.