Comparison of naproxen and piroxicam in the treatment of rheumatoid arthritis: a double-blind, crossover study.

A double-blind, crossover study was carried out in 50 patients with rheumatoid arthritis to compare the efficacy and tolerance of single evening doses of 1000 mg naproxen and 20 mg piroxicam. After an initial wash-out period of 1 week, patients received 4-weeks' treatment with one or other of the trial drugs and were then crossed over after a 1-week wash-out period to the alternative medication for a further 4 weeks. Objective assessments of disease activity and patients' and physician's assessments of therapeutic response were made at the end of each wash-out and active treatment period, and at the end of the trial patients and physician were asked to say which of the two active treatments was preferred. Forty-nine patients completed the 10-week trial; one patient discontinued the study while on piroxicam therapy because of side-effects. While both treatments proved effective, naproxen was statistically significantly better than piroxicam for total joint pain, grip strength, duration of morning stiffness, and overall therapeutic response. Naproxen also had a more rapid and more pronounced action than did piroxicam and was selected as the preferred drug by both patients and physicians. Patients taking naproxen reported slightly fewer side-effects than did those taking piroxicam.