Yaseen Mohammed1, Sarala Narayana1, HS Arun2
1Department of Pharmacology, Sri Devaraj Urs Medical College, Sri Devaraj Urs Academy of Higher Education and Research, Kolar, Karnataka, India.
2Department of Orthopaedics, Sri Devaraj Urs Medical College, Sri Devaraj Urs Academy of Higher Education and Research, Kolar, Karnataka, India.
Introduction: Osteoarthritis (OA) is a degenerative joint disease and cause for functional disability. OA is characterized by the insidious onset of pain and limited range of movements. Piroxicam and naproxen are used in OA, rheumatoid arthritis, acute gouty arthritis, migraine, dysmenorrhea, and postoperative pain. The aim of this study was to compare the efficacy and safety of these drugs in patients with OA of the knee. Materials and Methods: This was a randomized, open-label, comparative, parallel group study conducted in patients with OA of knee joints. They received either oral piroxicam 20 mg or naproxen 500 mg twice daily for 6 weeks. The pain was assessed using Visual Analog Scale (VAS) and Western Ontario and McMaster Universities Arthritis Index (WOMAC) scores at baseline, 2nd, 4th, and 6th week. Patient satisfaction score (PSS) and quality of life were assessed at follow-up. Adverse effects were assessed using the World Health Organization causality scale. Descriptive and inferential statistics were used. Results: A total of 110 patients were recruited, 47 males and 63 females, 100 completed the study (51 in Group P and 49 in Group N). Both piroxicam and naproxen significantly reduced VAS and WOMAC scores at the 2nd, 4th, and 6th week (P = 0.001) compared to baseline, but this was not significant between the groups. PSS was significantly (P = 0.03) high at 4th and 6th week when compared to week 2 with both medications, but between the medications, it was insignificant (P = 0.10). The adverse effects such as epigastric discomfort, nausea, and vomiting were observed with both the drugs, but it was more with naproxen. Conclusion: Piroxicam was as effective as naproxen in relieving pain and improving the range of movements with less adverse effects.
Keywords: Knee joints, Naproxen, Osteoarthritis, Piroxicam.