Naproxen suppositories in combination with oral naproxen, indomethacin and ibuprofen in the treatment of rheumatoid arthritis

Abstract

A single-blind, crossover trial was carried out in 30 rheumatoid arthritis patients to compare the effectiveness and tolerance of 250 mg naproxen, 400 mg ibuprofen and 25 mg indomethacin twice daily in patients treated concurrently with a night-time 500 mg naproxen suppository. Each day-time drug was given for 3 weeks. Naproxen suppositories were used for the whole 9 weeks of the study. No difference between the combination treatments was seen in pain and morning stiffness, while articular index and P.I.P. joint size tended to improve most during the naproxen tablet and suppository phase. Patients' and physician's preferences were both significantly in favour of the naproxen tablet and suppository phase. Side-effects were similar during all treatment phases, except for vertigo which occurred during the indomethacin capsule and naproxen suppository phase. Combinations of two non-steroidal, anti-inflammatory drugs have been shown to be effective and well tolerated but to have no advantage over treatment with only one drug. Naproxen suppositories have been shown to be well tolerated over a 9-week period.