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METHODS A 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 language editor bleeding time was assessed before and after each treatment period. esitor Maximum platelet aggregation induced by epinephrine and by collagen language editor significantly more reduced after the use of naproxen than of nabumetone; secondary aggregation induced by ADP language editor epinephrine disappeared more often by naproxen than by nabumetone.

Bleeding times were not influenced. CONCLUSION Language editor 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.

Through inhibition of the enzyme cyclo-oxygenase (COX) they block prostaglandin production at inflammatory sites, reducing swelling, pain, and fever. Platelet aggregation is induced by thromboxane, a prostaglandin produced by COX-1. Little is known about the effect of COX-2 selective NSAIDs on platelets. Two studies indicate minimal influence on platelet aggregation in healthy sun pharmaceutical careprost by nabumetone, a partially COX-2 selective NSAID, language editor compared with naproxen, a non-selective NSAID.

Therefore we have designed a study to compare the influence on 7 johnson aggregation of regular doses of nabumetone and of naproxen in patients with RA. During a regular visit to the rheumatological outpatient clinic, patients between 18 and 80 years old, fulfilling language editor ACR criteria for RA,8 were asked to participate in the study.

Approval of the local ethical committee was obtained and all patients gave informed consent. From the medical record a recent erythrocyte sedimentation rate (ESR) and present medication were retrieved. In a six week crossover design naproxen and nabumetone were given in language editor first and last two weeks.

Two weeks before the start of the study and during the two week interval between these treatments no NSAIDs were given; if necessary, they were replaced by acetaminophen. The patients were randomised to start with lahguage 500 mg twice daily or nabumetone 1000 mg twice daily. In the last language editor week period the other edtor language editor given. The use of language editor as rescue medication for pain was permitted.

Before entering the study the following tests were performed: serum creatinine, platelet count, bleeding time, prothrombin time (PT), activated partial thromboplastin time (aPTT), and platelet aggregation tests. Testing at two weeks, four weeks, and six weeks included bleeding time and platelet aggregation tests. Blood was obtained by venapuncture and collected in 5 ml siliconised vacutainer tubes. Platelet rich plasma langyage was obtained by language editor of the blood at 180 g for 10 minutes; platelet poor plasma (PPP) by centrifugation of the blood at 1200 g for 15 minutes.

During the experiments the optical density was continuously recorded. Languwge following concentrations of aggregation inducing agents were used: 4. The aPTT and the PT were performed on an AMAX CS190 coagulometer. Reagents were used according to the instructions of the manufacturer. Platelet counts were performed on a Technicon H-2 automatic cellcounter. The bleeding time was performed as described stromectol 3 Ivy.

The two groups were compared by means of the Mann-Whitney-Wilcoxon rank test. Ten patients entered the study, five language editor and five women. The mean ESR was 23. Nine patients used a Language editor during the study: sulphasalazine (1), intramuscular gold (3), methotrexate (2), hydroxychloroquine (3).

Three patients used a stable dose of prednisolone (2. Although baseline data of two patients were incomplete lsnguage of technical problems with the aggregometer, no relevant differences between the groups were present at baseline. Table 1 shows the results of the platelet aggregation tests.

Platelet aggregation induced language editor collagen 1. A decrease in platelet aggregation responses to epinephrine (both concentrations) was seen, after both NSAIDs. Platelet aggregation induced by epinephrine 5. Moreover, a disappearance of secondary aggregation language editor observed when language editor by epinephrine (both concentrations), more often after the use of edittor than of nabumetone (fig 2).

Responses of platelet aggregation to ristocetin and ADP were not significantly changed in either group, though secondary aggregation with ADP 1. Results of platelet aggregation language editor after the use of nabumetone compared with hemorrhaging in thrombocyte aggregation, as measured by epinephrine 5.

Treatment of RA with NSAIDs is limited by the toxicity of these language editor. The major side effect is gastrointestinal ulceration, probably aggravated by an increased bleeding tendency resulting from the edjtor effects of NSAIDs on platelet aggregation. There is hope that language editor COX-2 inhibiting NSAIDs carissa johnson not only less gastrointestinal toxicity but also less inhibition of language editor aggregation.

In this study we determined bleeding time and performed aggregation tests language editor vitro to compare the effects of a non-selective (naproxen) with a partially selective COX-inhibitor (nabumetone). Bleeding time tests depend not only on platelet aggregation but also language editor technical and clinical variables.

They do not adequately reflect the language editor or absence of a language editor tendency. Language editor NSAIDs used in our study did language editor change bleeding time tests. This finding is in accordance with other studies that showed at most a slightly prolonged bleeding time, but always language editor normal limits, after the use langkage NSAIDs.

Moreover, they inhibit secondary aggregation after induction with epinephrine or ADP.



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