Pred versus Naproxin
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I am sure there is a sensible answer to this question, else we would not all be taking Pred. But why can't PMR be treated with Naproxin (and Omeprazole alongside to protect the stomach), as I thought this was a non-steroid anti- inflammatory medicine?
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christine_fay Herbo
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pat38625 Herbo
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EileenH Herbo
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PMR is not the disease - it is the name given to a set of symptoms and there are quite a few different causes. In our case it is most probably an underlying autoimmune disorder that leads to a vasculitis which manifests as GCA or PMR or both depending on which blood vessels are affected. There is some evidence that white blood cells called neutrophils may be involved and pred probably acts on neutrophils to achieve its effect.
The combination of Naproxen and omeprazole long term is pretty foul in terms of side effects too - omeprazole can cause osteoporosis all on its own, doesn't work as an acid suppressant in about 1/3 or patients and can cause all sorts of other things - google its side effects to find a list that isn't significantly different from pred. Naproxen is possibly "less" gastroirritant than other NSAIDs such as aspirin and ibuprofen but, as I keep saying, less is not none, and the list of its possible side effects actually makes pred look pretty benign. Pred doesn't damage kidneys for a start. And you're looking at using 2 modern drugs whose full spectrum of long term side effects is not clear. Pred has been in use for 60 years - there isn't a lot left to find out about it.
Pred may not be perfect - but if you sit down and look at it realistically, it isn't too bad at all. There ARE serious side effects but that applies to most things. If I have to have side effects I would rather have it from something that works reasonably well. and PMR also has side effects if untreated - uncontrolled inflammation in the body can lead to a lot of unpleasant consequences including cardiovascular diseases and cancer.
In the case of GCA there is no choice - high dose pred or risk going blind. It makes the trials of new drugs more difficult of course - it isn't ethical to do a double blind study on someone at risk of losing their sight if the new drug isn't guaranteed to prevent it. Even with pred you may be too late.
Herbo
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EileenH Herbo
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