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DG DISPATCH - ACR: Naproxen For Children With Rheumatic Fever By Maria Bishop Special to DG News BOSTON, MA -- November 16, 1999 -- Although other nonsteroidal anti-inflammatory drugs (NSAIDs) have replaced Aspirin (acetylsalicylic acid) as first-line therapy for most childhood rheumatic conditions, very few cases have been reported on the use of NSAIDs other than Aspirin in treating childhood rheumatic fever (RF). Now, research from Israel shows that naproxen appears to be effective for the treatment of RF-related arthritis and fever, and is well tolerated by the pediatric age group, too. Dr. Philip J. Hashkes and colleagues presented results of a clinical study involving 19 children (ranging in age from four to 14, with a mean age of nine) at the Pediatric Rheumatology II poster session of the 63rd Annual Scientific Meeting of the American College of Rheumatology (ACR), in Boston, MA, The study was conducted at pediatric departments of hospitals in Galilee, Kfar-Saba and Tel-Hashomer, Israel, In the participating pediatric departments, researchers conducted a retrospective chart review on children who were diagnosed with RF between 1994 and 1998. The median duration of fever and arthritis before the start of naproxen was four days. The mean erythrocyte sedimentation rate (ESR) level at diagnosis was 84 +/- 35 mm/h. None of the children had carditis, chorea or rash. All patients met the revised Jones criteria and were treated by naproxen solely (10-20 mg/kg/daily, divided in two doses). Clinical response and side effects were then reviewed. Following naproxen therapy, fever and arthritis resolved within a median of one day and responses for fever ranged from one to two days and for arthritis from one to 30 days. (The one patient with prolonged arthritis had small-joint involvement.) The investigators observed no gastrointestinal, liver or renal side effects; neither did they observe any relationship between the duration of fever and arthritis prior to therapy and the time of response. During a six-month follow-up, none of the patients were found to have developed carditis. All of these results led the investigative team to conclude that naproxen appears to be effective for the treatment of RF-related arthritis and fever, and that it is well tolerated by children. Related Links: Aspirin (acetylsalicylic acid). E-mail this page to a friend or colleague! To print, use this version