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a Department
of Rheumatology, Medisch Spectrum Twente Enschede, the Netherlands, b Department of Clinical Laboratory, Twenteborg
Hospital, Almelo, the Netherlands
Correspondence to: Dr E A J Knijff-Dutmer, Rheumatology Twente, Twenteborg Hospital, PO Box 7600, 7600 SZ Almelo, the Netherlands.
Accepted for publication 11 January 1999
OBJECTIVE
To
test the hypothesis that nabumetone (a partially selective
cyclo-oxygenase-(COX)-2 inhibitor) has less effect on platelet aggregation than naproxen (a non-selective COX-inhibitor) in patients with rheumatoid arthritis (RA).
METHODSA crossover
study in 10 RA patients was performed, using either nabumetone or
naproxen for two weeks, and, after a washout period of two weeks, the
other drug during another two weeks. Platelet aggregation studies were
performed and bleeding time was assessed before and after each
treatment period.
RESULTSMaximum
platelet aggregation induced by epinephrine and by collagen was
significantly more reduced after the use of naproxen than of
nabumetone; secondary aggregation induced by ADP and epinephrine disappeared more often by naproxen than by nabumetone. Bleeding times
were not influenced.
CONCLUSIONCOX
dependent platelet aggregation in RA patients seems to be more
inhibited by naproxen than by nabumetone. This may be relevant for
patients requiring non-steroidal anti-inflammatory drug treatment but
who have an increased risk of bleeding as well.
This article has been cited by other articles:
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 E.A.J. Knijff-Dutmer, J. Van der Palen, G. Schut, and M.A.F.J. Van de Laar The influence of cyclo-oxygenase specificity of non-steroidal anti-inflammatory drugs on bleeding complications in concomitant coumarine users QJM, July 1, 2003; 96(7): 513 - 520. [Abstract] [Full Text] [PDF]
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 P. T. Leese, D. P. Recker, and J. D. Kent The COX-2 Selective Inhibitor, Valdecoxib, Does Not Impair Platelet Function in the Elderly: Results of a Randomized Controlled Trial J. Clin. Pharmacol., May 1, 2003; 43(5): 504 - 513. [Abstract] [Full Text] [PDF]
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 E. A. J. Knijff-Dutmer, E. M. Kalsbeek-Batenburg, J. Koerts, and M. A. F. J. van de Laar Platelet function is inhibited by non-selective non-steroidal anti-inflammatory drugs but not by cyclo-oxygenase-2-selective inhibitors in patients with rheumatoid arthritis Rheumatology, April 1, 2002; 41(4): 458 - 461. [Abstract] [Full Text] [PDF]
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 G. A. FitzGerald and C. Patrono The Coxibs, Selective Inhibitors of Cyclooxygenase-2 N. Engl. J. Med., August 9, 2001; 345(6): 433 - 442. [Full Text] [PDF]
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