NSAIDS Don't Affect C-Reactive Protein Levels in RA Patients

Stratified analysis of specific NSAIDs show significant effect; naproxen tied to decrease in CRP

THURSDAY, Nov. 1 (HealthDay News) -- Overall, oral nonsteroidal anti-inflammatory drugs (NSAIDs) do not have an effect on C-reactive protein (CRP) levels in patients with rheumatoid arthritis (RA), according to research published in the November issue of Arthritis & Rheumatism.

Simon Tarp, from the Copenhagen University Hospital in Denmark, and colleagues reviewed the literature to identify parallel-group, randomized, placebo-controlled trials of oral NSAID therapy in RA patients for which there were extractable CRP data to evaluate the effects of oral NSAIDs on CRP levels. Using a random-effects model for meta-analysis, the overall change in CRP levels was estimated.

The researchers found that, in the 19 included trials involving 10 different NSAIDs, there was no overall effect on CRP levels. Based on a prespecified, stratified analysis, varying effects on the CRP level were noted for different NSAIDs: lumiracoxib correlated with a significant and consistent increase in the CRP level (P = 0.037), while naproxen correlated with a significant and consistent decline in the CRP level (P = 0.022).

"We conclude that NSAIDs as a group have no effect on the CRP level, although they are analgesic and may be anti-inflammatory in RA assessed by parameters other than the CRP level," the authors write. "Given the proposed cardioprotective properties of naproxen, and based on the present analysis, we suggest that this nonselective NSAID could be a potential choice for patients with cardiac risk factors in rheumatology practice."

Mundipharma International sponsored the study; Merck & Company provided the unpublished data and reviewed the manuscript.

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