Re: RESEARCH - OTC naproxen trumps OTC ibuprofen for knee OA pain

[Guest guest]

I've also found that naproxen is better than ibuprofen for RA. I was afraid

I wouldn't find something as effective as vioxx, but I'm happy to say that

the naproxen is helping.

a

> OTC naproxen trumps OTC ibuprofen for knee OA pain

>

> Rheumawire

> Aug 23, 2004

> Mann

>

> Denver, CO - Over-the-counter naproxen sodium at usual doses of 440 or

> 660 mg/day is better than ibuprofen (1200 mg/day) at relieving symptoms

> of mild to moderate knee osteoarthritis (OA), according to a Hoffmann-La

> Roche-funded study in the July 2004 issue of the Journal of

> Rheumatology. The benefits of naproxen were particularly evident in

> older patients, Dr Schiff (Denver Arthritis Clinic, CO) and Dr

> Milos Minic (Hoffmann-La Roche AG, Basel, Switzerland) report [1]. " OTC

> NSAIDs are a choice for our patients with mild OA, " Schiff tells

> rheumawire. " Their safety is very good, and naproxen sodium has a good

> dosing and efficacy profile. " (Roche markets nonprescription Anaprox and

> Naprosyn naproxen products.)

>

> The new study was a secondary analysis of 2 identical multicenter,

> randomized, double-blind, placebo-controlled, multidose, parallel-design

> studies conducted in the US. Both trials were completed in May and

> October of 1996. In these trials, patients aged >25 years with OA were

> randomized to receive daily doses of naproxen, ibuprofen, or placebo.

> The naproxen dose was 660 mg, except that patients >65 years received

> naproxen sodium at 440 mg. The ibuprofen dose was 1200 mg. Patients

> received the blinded treatment or placebo for 7 days. They were observed

> for 8 days.

>

> The initial cohort included 461 patients with radiographic knee OA

> changes documented within the previous 3 years and including at least 1

> of the following: subchondral sclerosis; joint-space narrowing; presence

> of osteophytes or marginal lipping; or cyst formation in the knee joint

> typical of OA stage 1-3. All had episodic knee OA flares with at least

> moderate pain on weight bearing. Nine patients either did not take study

> medication or were lost to follow-up, leaving 452 patients in the safety

> analysis: 148 randomized to naproxen, 152 randomized to ibuprofen, and

> 152 randomized to placebo. In the efficacy analysis 8 patients were

> excluded for various reasons.

>

> In the total population both investigator assessments and patient

> assessments of knee joint pain showed that naproxen and ibuprofen were

> better than placebo at relieving pain on passive motion, pain on weight

> bearing, stiffness after rest, day pain, and 50-foot walk time. Only

> naproxen significantly improved pain at rest and night pain compared

> with placebo. Both treatments reduced the mean symptom score by 30% to

> 45%, compared with a 20% to 25% reduction with placebo.

>

> For the subgroup of patients aged >65 years, naproxen sodium 440 mg was

> significantly superior to placebo in all symptoms except pain on weight

> bearing, while ibuprofen significantly reduced only day pain.

>

> According to patient diaries, naproxen sodium and ibuprofen were both

> effective in reducing all 6 symptoms (which included overall arthritis

> pain control from study medication, overall pain last night,

> difficulties experienced walking 1 block or climbing 1 flight of steps,

> difficulties in walking several blocks or climbing several flights of

> stairs, and difficulties in bending, lifting, and stooping). There was a

> (nonsignificant) trend toward higher efficacy for nighttime pain with

> naproxen compared with ibuprofen.

>

> There were no significant differences in adverse events, the most common

> of which were gastrointestinal side effects in all groups. The most

> frequent single adverse effect was headache. One case of rectal

> hemorrhage in the ibuprofen group was rated as mild and probably related

> to study medication.

>

> The researchers note, " Pain, especially during the night, is the most

> common reason patients with OA seek medical help. " They conclude: " These

> data indicate that in short-term management of OA of the knee, naproxen

> sodium 440/660 mg on an as-needed basis provides patients with effective

> analgesia, potentially enabling them to lead an active life and sleep

> sufficiently at night. "

>

> Source

>

> Schiff M and Minic M. Comparison of the analgesic

> efficacy and safety of nonprescription doses of naproxen sodium and

> Ibuprofen in the treatment of osteoarthritis of the knee. J Rheumatol.

> 2004; 31:1373-83.

>

>

>

>

> I'll tell you where to go!

>

> Mayo Clinic in Rochester

> http://www.mayoclinic.org/rochester

>

> s Hopkins Medicine

> http://www.hopkinsmedicine.org

>

>

>

>

>

[Guest guest]

I've also found that naproxen is better than ibuprofen for RA. I was afraid

I wouldn't find something as effective as vioxx, but I'm happy to say that

the naproxen is helping.

a

> OTC naproxen trumps OTC ibuprofen for knee OA pain

>

> Rheumawire

> Aug 23, 2004

> Mann

>

> Denver, CO - Over-the-counter naproxen sodium at usual doses of 440 or

> 660 mg/day is better than ibuprofen (1200 mg/day) at relieving symptoms

> of mild to moderate knee osteoarthritis (OA), according to a Hoffmann-La

> Roche-funded study in the July 2004 issue of the Journal of

> Rheumatology. The benefits of naproxen were particularly evident in

> older patients, Dr Schiff (Denver Arthritis Clinic, CO) and Dr

> Milos Minic (Hoffmann-La Roche AG, Basel, Switzerland) report [1]. " OTC

> NSAIDs are a choice for our patients with mild OA, " Schiff tells

> rheumawire. " Their safety is very good, and naproxen sodium has a good

> dosing and efficacy profile. " (Roche markets nonprescription Anaprox and

> Naprosyn naproxen products.)

>

> The new study was a secondary analysis of 2 identical multicenter,

> randomized, double-blind, placebo-controlled, multidose, parallel-design

> studies conducted in the US. Both trials were completed in May and

> October of 1996. In these trials, patients aged >25 years with OA were

> randomized to receive daily doses of naproxen, ibuprofen, or placebo.

> The naproxen dose was 660 mg, except that patients >65 years received

> naproxen sodium at 440 mg. The ibuprofen dose was 1200 mg. Patients

> received the blinded treatment or placebo for 7 days. They were observed

> for 8 days.

>

> The initial cohort included 461 patients with radiographic knee OA

> changes documented within the previous 3 years and including at least 1

> of the following: subchondral sclerosis; joint-space narrowing; presence

> of osteophytes or marginal lipping; or cyst formation in the knee joint

> typical of OA stage 1-3. All had episodic knee OA flares with at least

> moderate pain on weight bearing. Nine patients either did not take study

> medication or were lost to follow-up, leaving 452 patients in the safety

> analysis: 148 randomized to naproxen, 152 randomized to ibuprofen, and

> 152 randomized to placebo. In the efficacy analysis 8 patients were

> excluded for various reasons.

>

> In the total population both investigator assessments and patient

> assessments of knee joint pain showed that naproxen and ibuprofen were

> better than placebo at relieving pain on passive motion, pain on weight

> bearing, stiffness after rest, day pain, and 50-foot walk time. Only

> naproxen significantly improved pain at rest and night pain compared

> with placebo. Both treatments reduced the mean symptom score by 30% to

> 45%, compared with a 20% to 25% reduction with placebo.

>

> For the subgroup of patients aged >65 years, naproxen sodium 440 mg was

> significantly superior to placebo in all symptoms except pain on weight

> bearing, while ibuprofen significantly reduced only day pain.

>

> According to patient diaries, naproxen sodium and ibuprofen were both

> effective in reducing all 6 symptoms (which included overall arthritis

> pain control from study medication, overall pain last night,

> difficulties experienced walking 1 block or climbing 1 flight of steps,

> difficulties in walking several blocks or climbing several flights of

> stairs, and difficulties in bending, lifting, and stooping). There was a

> (nonsignificant) trend toward higher efficacy for nighttime pain with

> naproxen compared with ibuprofen.

>

> There were no significant differences in adverse events, the most common

> of which were gastrointestinal side effects in all groups. The most

> frequent single adverse effect was headache. One case of rectal

> hemorrhage in the ibuprofen group was rated as mild and probably related

> to study medication.

>

> The researchers note, " Pain, especially during the night, is the most

> common reason patients with OA seek medical help. " They conclude: " These

> data indicate that in short-term management of OA of the knee, naproxen

> sodium 440/660 mg on an as-needed basis provides patients with effective

> analgesia, potentially enabling them to lead an active life and sleep

> sufficiently at night. "

>

> Source

>

> Schiff M and Minic M. Comparison of the analgesic

> efficacy and safety of nonprescription doses of naproxen sodium and

> Ibuprofen in the treatment of osteoarthritis of the knee. J Rheumatol.

> 2004; 31:1373-83.

>

>

>

>

> I'll tell you where to go!

>

> Mayo Clinic in Rochester

> http://www.mayoclinic.org/rochester

>

> s Hopkins Medicine

> http://www.hopkinsmedicine.org

>

>

>

>

>