Premium
Effect of naproxen on the hypothalamic–pituitary– adrenal axis in healthy volunteers
Author(s) -
Eijsbouts Agnes M. M.,
Kempers Marlies J. E.,
Kramer Renske S. A.,
Hopman Maria T. E.,
Van Den Hoogen Frank H. J.,
Laan Ronald F. J. M.,
Hermus Ad R. M. M.,
Sweep Fred C. G. J.,
Van De Putte Leo B. A.
Publication year - 2009
Publication title -
british journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.216
H-Index - 146
eISSN - 1365-2125
pISSN - 0306-5251
DOI - 10.1111/j.1365-2125.2008.03324.x
Subject(s) - naproxen , medicine , endocrinology , hypothalamic–pituitary–adrenal axis , adrenocorticotropic hormone , basal (medicine) , placebo , circadian rhythm , hydrocortisone , rheumatoid arthritis , saliva , cortisol awakening response , hormone , alternative medicine , pathology , insulin
WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT • In patients with rheumatoid arthritis (RA) the activity of the hypothalamic– pituitary–adrenal (HPA) axis is decreased. WHAT THIS STUDY ADDS • It is not known how the frequent use of nonsteroidal anti‐inflammatory drugs (NSAIDs) in patients with RA influences the HPA axis. • In this study the effect of the NSAID naproxen on HPA axis activity was tested in healthy volunteers. • Two weeks' use of naproxen did not influence the activity of the HPA axis in healthy volunteers under basal circumstances, nor in response to physical stress. AIM To study the effect of the nonsteroidal anti‐inflammatory drug naproxen on the activity of the hypothalamic–pituitary–adrenal (HPA) axis in healthy volunteers. METHODS A double‐blind, randomized study in two groups of 20 healthy volunteers was performed. The activity of the HPA axis was measured before and after the use of naproxen or placebo during a period of 2 weeks. Basal plasma adrenocorticotropic hormone (ACTH) and cortisol, 24‐h urinary cortisol, and circadian cortisol rhythm in saliva were determined. Plasma ACTH and cortisol were also measured during submaximal physical exercise. RESULTS There were no significant differences between the placebo and naproxen groups in basal plasma ACTH [09.00 h 3.1 pmol l −1 , 95% confidence interval (CI) 2.0, 4.2, and 2.8 pmol l −1 , 95% CI 1.9, 3.7, respectively], cortisol levels (09.00 h 0.45 µmol l −1 , 95% CI 0.39, 0.51, and 0.40 µmol l −1 , 95% CI 0.35, 0.44, respectively), 24 h urinary cortisol excretion (67.5 nmol 24 h −1 , 95% CI 54.3, 80.7, and 86.8 nmol 24 h −1 , 95% CI 54.4, 119.2, respectively), circadian cortisol rhythm measured in salivary samples, or ACTH and cortisol concentrations after physical exercise. After the use of placebo or naproxen for 2 weeks, no significant change in any of the parameters occurred (ACTH 09.00 h 3.0 pmol l −1 , 95% CI 2.0, 3.9, and 3.0 pmol l −1 , 95% CI 2.2, 3.8, respectively; cortisol 09.00 h 0.45 µmol l −1 , 95% CI 0.37, 0.52, and 0.39 µmol l −1 , 95% CI 0.34, 0.44, respectively; cortisol urine 79.5 nmol 24 h −1 , 95% CI 59.5, 99.4, and 81.7 nmol 24 h −1 , 95% CI 64.0, 99.4, respectively), and no significant differences were found in these parameters between the placebo and naproxen groups. CONCLUSIONS The use of naproxen does not influence the activity of the HPA axis in healthy volunteers under basal circumstances or in response to physical stress.