Double-blind crossover comparison of piroxicam and naproxen in the treatment of active osteoarthritis.

Since the initial marketing in the early 1970s of the nonsteroidal anti-inflammatory agents of the propionic acid type, there has been a gradual escalation of the dosage recommendation for each of these drugs. In contrast, the dosage recommendation for piroxicam has remained constant. In this 12-week, double-blind crossover study, the standard dose of piroxicam 20 mg/d has been compared with the newly recommended dosage of naproxen 500 mg twice a day in 19 patients with active osteoarthritis. In the piroxicam treatment interval, there was statistically significant improvement in six of nine clinical parameters as compared with five of nine clinical parameters for the naproxen treatment interval. Adverse experiences with both drugs were mild to moderate. Both piroxicam and naproxen resulted in statistically significant improvement in right grip strength, the time to walk 50 feet, daily activity assessment, and in the total joint pain. In addition, piroxicam resulted in statistically significant improvement in both the physician and patient assessment of disease activity. Naproxen treatment was associated with a statistically significant decrease in total joint swelling.