Thirty patients, 23 women and 7 men, with classical or definite rheumatoid arthritis (ARA criteria) were given naproxen and indomethacin in a controlled, double-blind cross-over trial. Each patient was given naproxen 250 mg twice daily 4 weeks and 50 mg indomethacin three times daily 4 weeks. The patients were evaluated for drug efficacy and toxicity every second week. Joint pain, tenderness, swelling, heat or erythema, duration of morning stiffness, grip strength and laboratory examinations were recorded.Of the 26 patients that completed the study, 11 patients preferred naproxen, 9 preferred indomethacin and 6 patients evaluated the drugs as equally efficient. In the total clinical evaluation, naproxen was best in 7 patients, indomethacin was best in 5 patients and in 14 patients there were no definite differences between the two drugs. The average sedimentation rate (Westergren, 1 h) showed a statistically significant decrease in values with naproxen compared with indomethacin.Side-effects were more frequent and severe in patients receiving indomethacin than in those on naproxen. The latter consisted only of mild to moderate gastrointestinal complaints in one or possibly two patients. Indomethacin side-effects consisted mainly of headache, dizziness and gastrointestinal symptoms.In this series naproxen seemed to be as effective as indomethacin in the treatment of patients with rheumatoid arthritis of long duration and relatively high disease activity.
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O Kogstad (1973) studied this question.