Retrospecti̇ve compari̇son of the effi̇cacy ofacetylsali̇cyli̇c aci̇d and naproxen sodi̇um that areused i̇n anti̇-i̇nflammatory treatment i̇n the pati̇entswho are moni̇tored wi̇th acute rheumati̇c feverdi̇agnosi̇s

Purpose: To present the clinical and demographic features of ARF in children who live in Tekirdağ and compare the reliability and the efficacy of Acetylsalicylic Acid (80-100 mg/kg/day) and Naproxen Sodium (10-20 mg/kg/day) treatments that are used in the patients. Methods: All patient files that belong to those who applied to our Pediatric Cardiology polyclinic between January 2016 and December 2018 have been evaluated retrospectively and 65 patient files aged between 5 and 17 (average 11,82+2,79, M/F ratio:1,3) that were diagnosed with ARF have been evaluated retrospectively according to 2015 Jones criteria. The treatment efficacy of Acetylsalicylic Acid (ASA) and Naproxen Sodium (NXN) used in the anti-inflammatory treatment of these patients have been evaluated by comparing clinical, laboratory and ECO data before and after the diagnosis. Statistical Analysis: SPSS Statistics 25.0 for Windows Evaluation Version has been used. Statistical significance has been accepted as p<0, 05. Findings: The most commonly observed major indications were arthritis (72%) and carditis (75%) whereas the minor ones were fever (61%). In 59 patients that were diagnosed with arthritis, 32,2% migratory polyarthritis, 20,3% polyarthralgia, 30.% monoarthritis cases have been observed. 52,5% of 59 patients with arthritis indications were given NXN and 47,5% of them were given ASA in their anti-inflammatory treatment. With the acceptance of polyarthralgia as criterion in 2015 new Jones criteria, there has been an increase in the number of detected ARF cases. There wasn't a significant difference between two groups when the efficacy and the duration of arthritis/arthralgia treatment was compared (p>0.05). In 49, 2% of the patients clinical carditis and in 30, 8% subclinical carditis have been observed. In echocardiography, the most common cardiac valve involvement was 76% mitral insufficiency (MI) and 38% were aorta insufficiency (AI). In our study, it was determined that the patients with cardiac involvement in the routine ECOs, the improvement in valve 73 involvement and the regression in the acute phase reactants observed in the controls were similar in patients using NXN and ASA (p> 0.05). In 50% of the 28 cases that were given ASA treatment, side effects related to salicylate have been observed. In 35% of them a deficiency in LFT and in 4 cases (%14) tinnitus have been observed. LFT has been monitored continuously in routine intervals. In cases that were given NXN, 11% less side effect profile has been observed. Result: In our retrospective study conducted on ARF diagnosed patients who applied to Paediatric Cardiology polyclinic in university hospital in Tekirdağ, we have concluded that NXN is as efficient as ASA in ARF treatment. We wanted to elaborate the pros and cons that we came across such as the conformity of the usage of Naproxen Sodium and encountering less side effect profile, a better dosing in the treatment, a better patient adaptation as well as rarely observed hepatic toxicity. As shown in other studies, in our study we also think that Naproxen Sodium is a reliable and efficient alternative to ASA in ARF treatment. Therefore, we believe that NXN must be considered as an alternative first step medication in arthritis treatment related to ASA. Keywords: Acute Rheumatic Fever (ARF), Anti-Inflammatory Treatment, Acetylsalicylic Acid (ASA), Naproxen Sodium (NXN).