An Observer-Blind Crossover Study to Compare the Efficacies of Flurbiprofen, Indomethacin and Naproxen Given Orally and Rectally in the Relief of Night Pain and Morning Stiffness Due to Rheumatoid Arthritis

Abstract

An observer-blind three-period crossover study of flurbiprofen, indomethacin and naproxen was carried out in 56 patients with rheumatoid arthritis. The drugs were scheduled as two oral doses early in the day with a rectal suppository at night. The aims were to compare efficacy, principally as relief of night pain and morning stiffness, and safety. Flurbiprofen was clearly the most beneficial drug. Advantages over the comparators were demonstrated in terms of shorter duration of morning stiffness, reduced severity of night pain (compared with naproxen) and in the improvement in sleep quality experienced by the patients. Excellent tolerability of flurbiprofen was seen, it being equivalent to naproxen and superior to indomethacin. The results demonstrate that nocturnal and early daytime provision of flurbiprofen is a highly effective strategy for controlling the nocturnal pain and morning stiffness of rheumatoid arthritis.

Sleep Quality in Rheumatoid Arthritis: Relationship Between the Disease Severity, Depression, Functional Status and the Quality of Life

“…Placebo controlled studies have demonstrated that NSAIDs increase sleep quality [46, 47]. However, polysomnographic results have indicated that the administration of NSAIDs does not change the sleep architecture, sleep latency or sleep efficiency in patients with RA [48].…”

Flurbiprofen in the symptomatic management of rheumatoid arthritis: a valuable alternative

“…A manual review of complete reports eliminated 51 of them for the following reasons: administration path (7), review papers (4), pharmacokinetics studies (10) animal studies (9), indication (15), combined therapies (6), leading to the inclusion of the data of 14 studies (8,10,11,14,15,18,19,21,22,26–29). Four of them included naproxen as comparator (10,11,15,18), seven indomethacin (11,19,22,26–29), three aspirin (14,29), one ibuprofen (25) and one ketoprofen (8), accounting for a total of 1103 patient‐year. Four studies were multicentric (8,10,18,25).…”

“…Flurbiprofen is a non‐steroidal anti‐inflammatory agent of the phenylalkanoic acid series (ibuprofen, naproxen and ketoprofen) and has been shown in a number of pharmacological studies to be a potent and effective drug in the treatment of inflammatory conditions, notably, including rheumatoid diseases (8–29). Even then, flurbiprofen has been, since its marketing, mostly restricted to the ophthalmic, maxillofacial and gynaecological surgery spheres.…”