It is indicated for the symptomatic treatment of osteoarthritis, rheumatoid arthritis and ankylosing spondylitis in patients at risk of NSAID-associated gastric and/or duodenal ulcers in whom lower doses of naproxen or other NSAIDs are not sufficient.
Vimovo combines an NSAID and a proton pump inhibitor (PPI) in a single tablet. The PPI is released in the stomach but the enteric coating of naproxen prevents release of the NSAID until it reaches the small intestine, limiting its gastric toxicity.1
When offering an NSAID to patients with osteoarthritis or rheumatoid arthritis, NICE clinical guidelines recommend co-prescribing a PPI to provide gastroprotection.2,3
Two randomised, double-blind, multicentre studies assessed the efficacy of a fixed-dose combination of esomeprazole and naproxen in patients with osteoarthritis, rheumatoid arthritis or ankylosing spondylitis and a history of uncomplicated gastric or duodenal ulcers. Investigators randomised a total of 861 patients to receive a tablet containing either 20mg immediate-release esomeprazole and 500mg enteric-coated naproxen, or 500mg enteric-coated naproxen only, twice daily for six months.2
In a pooled analysis, the six-month incidence of gastric ulcers was significantly lower in the groups receiving the combination tablet than in those receiving only enteric-coated naproxen (p<0.001).4 The incidence of duodenal ulcers was also significantly lower in the groups receiving the combination preparation (study 1: p=0.003; study 2: p=0.007).
- Vimovo Summary of Product Characteristics, November 2010.
- NICE CG59: Osteoarthritis, February 2008.
- NICE CG79: Rheumatoid arthritis, April 2009.
- Goldstein J et al. Aliment Pharmacol Ther 2010; 32: 401-13.
Further information: AstraZeneca