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Research ArticlePediatric Rheumatology

A Prospective Study Comparing Celecoxib with Naproxen in Children with Juvenile Rheumatoid Arthritis

IVAN FOELDVARI, ILONA S. SZER, LAWRENCE S. ZEMEL, DANIEL J. LOVELL, EDWARD H. GIANNINI, JEFFERY L. ROBBINS, CHRISTINE R. WEST, GINA STEIDLE, SRIRAM KRISHNASWAMI and BRADLEY J. BLOOM
The Journal of Rheumatology January 2009, 36 (1) 174-182; DOI: https://doi.org/10.3899/jrheum.080073
IVAN FOELDVARI
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  • For correspondence: sprechstunde@kinderrheumatologie.de
ILONA S. SZER
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LAWRENCE S. ZEMEL
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DANIEL J. LOVELL
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EDWARD H. GIANNINI
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JEFFERY L. ROBBINS
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CHRISTINE R. WEST
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GINA STEIDLE
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SRIRAM KRISHNASWAMI
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BRADLEY J. BLOOM
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Abstract

Objective

To compare the efficacy and safety of celecoxib and naproxen in children with juvenile rheumatoid arthritis (JRA).

Methods

In this multicenter, randomized, double-blind, noninferiority study, subjects with JRA were randomized to receive a target dose of celecoxib 3 mg/kg bid or 6 mg/kg bid, or a target dose of naproxen 7.5 mg/kg bid for 12 weeks (maximum allowed dose = 600 mg total daily dose). The primary efficacy measure was the percentage of responders at Week 12 attaining the American College of Rheumatology pediatric 30% improvement criterion (ACR Pediatric-30).

Results

Both celecoxib doses were at least as effective as naproxen at Week 12 [ACR Pediatric-30 treatment differences: celecoxib 3 mg/kg bid – naproxen = 1.36% (95% CI –13.08 to 15.80); celecoxib 6 mg/kg bid – naproxen = 13.02% (95% CI –0.22 to 26.25)]. Celecoxib 6 mg/kg bid had a numerically higher response rate than celecoxib 3 mg/kg bid at all postrandomization visits and a numerically higher response rate than naproxen 7.5 mg/kg bid at Weeks 4, 8, and 12. Improvement in each ACR Pediatric-30 core set measure was comparable to or numerically higher for celecoxib 6 mg/kg bid than naproxen or celecoxib 3 mg/kg bid. Adverse event rates were similar for all treatment groups, except that gastrointestinal adverse events were more common in the naproxen group, although the difference was not statistically significant.

Conclusion

Celecoxib 3 mg/kg bid and 6 mg/kg bid were at least as effective as naproxen 7.5 mg/kg bid in treating the signs and symptoms of JRA over 12 weeks. All treatments were generally well tolerated.

Key Indexing Terms:
  • JUVENILE RHEUMATOID ARTHRITIS
  • CELECOXIB
  • NAPROXEN
  • AMERICAN COLLEGE OF RHEUMATOLOGY CRITERIA

Footnotes

    • Accepted for publication August 15, 2008.
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The Journal of Rheumatology
Vol. 36, Issue 1
1 Jan 2009
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A Prospective Study Comparing Celecoxib with Naproxen in Children with Juvenile Rheumatoid Arthritis
IVAN FOELDVARI, ILONA S. SZER, LAWRENCE S. ZEMEL, DANIEL J. LOVELL, EDWARD H. GIANNINI, JEFFERY L. ROBBINS, CHRISTINE R. WEST, GINA STEIDLE, SRIRAM KRISHNASWAMI, BRADLEY J. BLOOM
The Journal of Rheumatology Jan 2009, 36 (1) 174-182; DOI: 10.3899/jrheum.080073

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A Prospective Study Comparing Celecoxib with Naproxen in Children with Juvenile Rheumatoid Arthritis
IVAN FOELDVARI, ILONA S. SZER, LAWRENCE S. ZEMEL, DANIEL J. LOVELL, EDWARD H. GIANNINI, JEFFERY L. ROBBINS, CHRISTINE R. WEST, GINA STEIDLE, SRIRAM KRISHNASWAMI, BRADLEY J. BLOOM
The Journal of Rheumatology Jan 2009, 36 (1) 174-182; DOI: 10.3899/jrheum.080073
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