A double-blind study of the simple analgesic nefopam in rheumatoid arthritis

The role of pure analgesics in the management of rheumatoid arthritis (RA) remains uncertain. In a double-blind cross-over study of 27 patients, nefopam was a more effective analgesic than placebo when given as a supplement to anti-inflammatory drugs. Both early morning stiffness and grip strength were also improved, suggesting that these are associated with pain perception rather than any other aspect of inflammation. Side-effects occurred in 9 (35%) on nefopam and none on placebo. The results suggest a valuable supplementary role for analgesics such as nefopam in the treatment of RA.