Effects of Naproxen on Experimental Rhinovirus Colds: A Randomized, Double-Blind, Controlled Trial

▪ Objective: To determine whether naproxen, a propionic acid inhibitor of cyclooxygenase, alters the course of experimental rhinovirus colds.

▪ Design: A randomized, double-blind, controlled trial.

▪ Setting: Rhinovirus challenge model in volunteers cloistered in individual hotel rooms.

▪ Volunteers: Eighty-seven healthy young adults with serum neutralizing antibody titers of ≤ 1:2 to the challenge virus; 79 were evaluable.

▪ Intervention: Thirty-nine participants received naproxen (loading dose, 400 mg or 500 mg followed by 200 mg or 500 mg three times daily for 5 days). Forty participants received placebo. Treatment was started 6 hours after viral challenge.

▪ Measurements: Daily measurement of viral titers, symptoms, nasal mucus production, and nasal tissue use; incidence of infection and illness; and measurement of homotypic serum neutralizing antibody responses.

▪ Results: Viral titers and serum homotypic antibody responses were similar in the naproxen and placebo groups. Significant reductions in headache, malaise, myalgia, and cough occurred in the naproxen group. A 29% reduction was noted in the total (5-day) symptom score in the naproxen group (95% Cl, 16% to 42%).

▪ Conclusion: Naproxen treatment did not alter virus shedding or serum neutralizing antibody responses in participants with experimental rhinovirus colds, but it had a beneficial effect on the symptoms of headache, malaise, myalgia, and cough. Prostaglandins may be among the inflammatory mediators that play a role in the pathogenesis of rhinovirus colds.