OBJECTIVE: For the past quarter of a century, the medical treatment of rheumatoid arthritis has been both illustrated and influenced by the therapeutic pyramid. In this plan of sequential drug administration, the initial choice, the base of pyramid, is aspirin or one of the many other NSAIDs. Droxicam, a new NSAID, is a pro-drug of piroxicam and acts by inhibition of PGE2~. Although it belongs to oxicam family, it is characterized by being a pro-drug of piroxicam, the molecule undergoing conversion by hydrolysis once dissolved in the digestive tract. So, its analgesic and anti-inflammatory potentials are the same as those of piroxicam, but G-I trouble, its major adverse effect, is less troublesome. This study was aimed to evaluate the clinical efficacy and safety of Droxicam. METHODS: Thirty three cases of active RA had been selected, 20mg of Droxicam was administrated to them per oral daily for 4 weeks and changes in pain score, numbers of tender/swollen joints, severity of their tenderness/swelling, duration of morning stiffness, grip strength, ESR and side effects of the drug were estimated. RESULTS: l. Pain rated by the patients with visual analogue scale was improved. the average pain score decreased gradually as follows: 7.0 in preadministration, 5.0 in the second weeks of post-treatment and 3.7 in the fourth weeks. 2. The numbers of tender/swollen joints and severity of their tenderness/swelling were gradually decreased after treatment. 3. Average durations of morning stiffness were 70.6 minutes in pre-administration, 67.3 in 2weeks and 59.7 in 4weeks after treatment, and average grip strengths were 45.5, 45.8, and 47,5mmHg in orders. 4. Average ESR decreased after administration : 41.3mm/hour in pre-treatment and 32.3mm/hour in 4weeks after administration. 5. Untoward effects were G-I trouble, edema, dizziness and weight gain. CONCLUSIONS: In summary, Droxicam seems to be useful drug in the treatment of active PA. However, further longterm follow-up is necessary.