Comparison of naproxen and acetaminophen in a two-year study of treatment of osteoarthritis of the knee

Authors

  • H. James Williams MD,

    Corresponding author
    1. Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City
    2. Cooperative Systemic Studies of the Rheumatic Diseases group.
    • Division of Rheumatology, University of Utah School of Medicine, 50 North Medical Drive, Salt Lake City, UT 84132
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  • John R. Ward MD,

    1. Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City
    2. Cooperative Systemic Studies of the Rheumatic Diseases group.
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  • Marlene J. Egger PhD,

    1. Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City
    2. Cooperative Systemic Studies of the Rheumatic Diseases group.
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  • Rosemarie Neuner MD,

    1. Department of Medicine, State University of New York, Downstate Medical Center, Brooklyn
    2. Cooperative Systemic Studies of the Rheumatic Diseases group.
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  • Raye H. Brooks BS,

    1. Division of Rheumatology and Immunology, Vanderbilt University, Nashville, Tennessee
    2. Cooperative Systemic Studies of the Rheumatic Diseases group.
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  • Daniel O. Clegg MD,

    1. Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City
    2. Cooperative Systemic Studies of the Rheumatic Diseases group.
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  • Elizabeth H. Field MD,

    1. Department of Medicine, University of Iowa College of Medicine, and the Veterans Affairs Medical Center, Iowa City
    2. Cooperative Systemic Studies of the Rheumatic Diseases group.
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  • John L. Skosey MD, PhD,

    1. Department of Medicine, University of Illinois at Chicago
    2. Cooperative Systemic Studies of the Rheumatic Diseases group.
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  • Graciela S. Alarcón MD, MPH,

    1. Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham
    2. Cooperative Systemic Studies of the Rheumatic Diseases group.
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  • Robert F. Willkens MD,

    1. Division of Arthritis, Harborview Medical Center, Seattle, Washington
    2. Cooperative Systemic Studies of the Rheumatic Diseases group.
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  • Harold E. Paulus MD,

    1. Division of Rheumatology, School of Medicine, University of California, Los Angeles
    2. Cooperative Systemic Studies of the Rheumatic Diseases group.
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  • I. Jon Russell MD, PhD,

    1. University of Texas Health Science Center, San Antonio
    2. Cooperative Systemic Studies of the Rheumatic Diseases group.
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  • John T. Sharp MD

    1. Tifton, Georgia
    2. Cooperative Systemic Studies of the Rheumatic Diseases group.
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Abstract

Objective. To compare the relative safety and efficacy of naproxen and acetaminophen in the treatment of osteoarthritis (OA) of the knee. The major outcome measures were radiographic progression and withdrawal from the trial due to lack of efficacy.

Methods. One hundred seventy-eight patients with OA of the knee were enrolled in a 2-year prospective, controlled, double-blind multicenter trial and were randomly assigned to receive acetaminophen (ACT) or naproxen (NPX) treatment.

Results. After 6 weeks of treatment, modest improvement in pain on motion and in physician's global assessment was seen in both the ACT and the NPX groups, and the NPX group also had modest improvement in pain at rest and in 50-foot walk time. Sixty-two patients completed the 2-year study. Among these patients, radiographic progression was similar in the 2 treatment groups. Withdrawal from the trial due to lack of drug efficacy was slightly more frequent among patients in the ACT group (22% versus 16%), but withdrawal due to adverse drug effects was slightly more common in the NPX group (23% versus 18%).

Conclusion. The efficacy of ACT treatment and NPX treatment was similar, although it was slightly better for NPX. The toxicity rate was slightly lower with ACT. However, the high rate of withdrawal in both treatment groups suggests that neither is satisfactory for the treatment of OA.

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