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.

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.