Topical Ketoprofen Versus Placebo in Treatment of Acute Ankle Sprain in the Emergency Department

Serinken, Mustafa; Eken, Cenker; Eliçabuk, Hayri

doi:10.1177/1071100716650530

Cited by 10 publications

(4 citation statements)

References 15 publications

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“…The findings in the current study support what has been shown for human medicine, with ketoprofen (and diclofenac, although the latter is not registered for use in cattle) having the highest penetration through human skin (Cordero et al, 1997 ; Derry et al, 2017 ; Mazieres, 2005 ). TD ketoprofen has proven useful to treat acute pain resulting for sprains or strains in humans (Derry et al, 2017 ), while a ketoprofen gel was superior to placebo at 30 min after being applied to sprained ankles (Serinken et al, 2016 ). Studies in rats have similarly demonstrated that ketoprofen is superior to other NSAIDs for providing pain relief from TD application because of its higher skin permeability (Amagai et al, 2013 ).…”

Section: Discussionmentioning

confidence: 99%

“…This leads to a reduction in product costs compared to the rigours and expenses of parenteral formulations (Mills & Cross, 2006 ). Topically applied non‐steroidal anti‐inflammatory drugs (NSAIDs) are becoming increasingly popular in human medicine, including ketoprofen (Derry et al, 2017 ; Serinken et al, 2016 ). Topical NSAIDs also offer a better risk‐to‐benefit ratio than NSAIDs administered by other routes, including oral administration (Rafanan et al, 2018 ).…”

Section: Introductionmentioning

confidence: 99%

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A novel transdermal ketoprofen formulation for analgesia in cattle

Mills

Owens²,

Reinbold

et al. 2022

Vet Pharm & Therapeutics

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Ketoprofen is registered in many countries for injectable administration in cattle.Because it is soluble in a wide range of excipients, development of a novel transdermal (TD) ketoprofen formulation was pursued to provide a convenient and pain-free route of administration in cattle. One hundred and six excipient combinations were screened using in vitro techniques (Franz diffusion cells), with a 20% (w/v) ketoprofen formulation dissolved in a combination of 45%:45% (v/v) ethanol and isopropyl myristate (IPM) and 10% (v/v) eucalyptus oil achieving maximal penetration of ketoprofen through bovine skin. A bioavailability study was then conducted using a randomized cross-over design (n = 12), including IV, IM (both 3 mg/kg) and TD (10 mg/kg) ketoprofen formulations administered with a one-week washout period between administrations. The IV and IM formulation pharmacokinetic results were as expected. The C MAX , T max and AUC 0-Last were significantly higher (arithmetic mean ± SD) after TD administration (20.0 ± 6.5 μg/ml, 115 ± 17 min and 3940 ± 1324 μg*min/ml, respectively), compared to IM (11.0 ± 4.0 μg/ml, 74 ± 43 min and 2376 ± 738 μg*min/ml, respectively), although there were no significant differences for T ½β . However, dose corrected values C MAX and AUC inf were significantly higher for IM compared to TD. The arithmetic mean bioavailability (F) of the transdermal formulation was 50%. The plasma concentration of the TD formulation at a dose of 10 mg/kg was similar to the IM formulation at 3 mg/kg by 30 min post-dosing with an arithmetic mean ± SD of 7.97 ± 4.38 vs. 8.02 ± 3.55 μg/ ml, respectively. The TD formulation was generally well tolerated by cattle, although some local irritation along the site of application was noted after 12 h of exposure during the bioavailability study. Results indicate that this novel TD formulation provides a substantial improvement in administration convenience, may improve animal welfare and end-user safety through needle-free administration, and achieves similar plasma pharmacokinetics to the IM product when administered at 10 mg/kg.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A novel transdermal ketoprofen formulation for analgesia in cattle

Mills

Owens²,

Reinbold

et al. 2022

Vet Pharm & Therapeutics

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“…A Cochrane systematic review on topical NSAIDs for acute musculoskeletal pain published in 2015 was included [ 15 ]. This review was updated with an additional 18 studies: 11 compared to placebo [ 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 ], one compared to oral NSAIDs [ 60 ], three compared to topical NSAIDs [ 61 , 62 , 63 ], and three compared to other topical drugs [ 64 , 65 , 66 ].…”

Section: Resultsmentioning

confidence: 99%

Multidisciplinary Guidelines for the Rational Use of Topical Non-Steroidal Anti-Inflammatory Drugs for Musculoskeletal Pain (2022)

Shi

Shao

et al. 2023

JCM

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(1) Background: Topical non-steroidal anti-inflammatory drugs (NSAIDs) are one of the primary drugs for treating musculoskeletal pain. However, there are currently no evidence-based recommendations about drug selection, drug administration, drug interactions, and use in special populations or other pharmacology-related content of such medications. To this end, the Chinese Pharmaceutical Association Hospital Pharmacy Professional Committee developed multidisciplinary guidelines on using topical NSAIDs to treat musculoskeletal pain. (2) Methods: The guidelines development process followed the World Health Organization guideline development handbook, the GRADE methodology, and the statement of Reporting Items for Practice Guidelines in Healthcare. The guideline panel used the Delphi method to identify six clinical questions to be addressed in the guidelines. An independent systematic review team conducted a systematic search and integration of evidence. (3) Results: Based on the balance between the benefits and harms of an intervention, the quality of the evidence, patient preferences and values, and resource utilization, the guideline panel developed 11 recommendations and nine expert consensuses on using topical NSAIDs to treat acute and chronic musculoskeletal pain. (4) Conclusions: Based on the effectiveness and overall safety of topical NSAIDs, we recommend patients with musculoskeletal pain use topical NSAIDs and suggest high-risk patients use topical NSAIDs, such as those with other diseases or receiving other concurrent treatments. The evidenced-based guidelines on topical NSAIDs for musculoskeletal pain incorporated a pharmacist perspective. The guidelines have the potential to facilitate the rational use of topical NSAIDs. The guideline panel will monitor the relevant evidence and update the recommendations accordingly.

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“…They can be administered with minimal expertise [13] and offer a better risk-to-benefit ratio than NSAIDs administered by other routes, including oral [14]. Topical NSAIDs, such as ketoprofen [15], have proven to be effective analgesics for acute pain in humans [16]. Unfortunately, there are no commercially available transdermal formulations containing NSAIDs registered for use in cattle.…”

Section: Introductionmentioning

confidence: 99%

A Novel Transdermal Ketoprofen Formulation Provides Effective Analgesia to Calves Undergoing Amputation Dehorning

Mills

Ghodasara

Satake

et al. 2020

Animals

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There is a critical need to ensure that all cattle undergoing surgical husbandry procedures are provided effective pain relief. Non-steroidal anti-inflammatory drugs (NSAIDs) are most commonly used, and typically are administered by intramuscular (IM) injection. However, administration of NSAIDs via this route to large numbers of cattle which are handled only once or twice a year, typical of many rangeland beef production systems, presents significant occupational health and safety and mis-administration risks. To address this, a novel transdermal (TD) formulation of ketoprofen was developed, and its efficacy assessed in a study of 36 Holstein–Friesian calves which were assigned to a placebo (n = 10), a TD ketoprofen (n = 10), an IM ketoprofen (n = 10) and sham dehorned group (n = 6). TD ketoprofen significantly reduced plasma cortisol concentrations between 1 to 4 h after dehorning compared to placebo treated calves, with concentrations at 2 and 4 h being very similar to those for sham dehorned calves. The expected log count of positively associated pain variables (ear flick, tail wag, ruminating, head shake, lying down, grooming and neck extending) in the TD group was reduced by 42%, compared to placebo calves, with an overall significant (p < 0.05) treatment effect. The IM group exhibited similar responses and both TD and IM cattle had a higher BW gain at 2 and 5 (p < 0.05) weeks post-dehorning, compared to placebo. This study has shown that TD administered ketoprofen was at least as effective as IM to control pain associated with dehorning and facilitates the administration of analgesic drugs prior to the surgical husbandry procedures being performed.

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Topical Ketoprofen Versus Placebo in Treatment of Acute Ankle Sprain in the Emergency Department

Abstract: Level I, high quality prospective randomized study.

Cited by 10 publications

References 15 publications

A novel transdermal ketoprofen formulation for analgesia in cattle

A novel transdermal ketoprofen formulation for analgesia in cattle

Multidisciplinary Guidelines for the Rational Use of Topical Non-Steroidal Anti-Inflammatory Drugs for Musculoskeletal Pain (2022)

A Novel Transdermal Ketoprofen Formulation Provides Effective Analgesia to Calves Undergoing Amputation Dehorning

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