Treatment of osteoarthritis of the knee with a topical diclofenac solution: a randomised controlled, 6-week trial [ISRCTN53366886]

Abstract

Background: Topical NSAIDs have been proven to relieve the symptoms of osteoarthritis (OA) in short-term studies (2 weeks). To justify its chronic use, efficacy of a topical NSAID over a longer term of study should be demonstrated. The efficacy and safety of a topical diclofenac solution over a 6-week treatment course in symptomatic primary OA of the knee was investigated.

Comparison of the Effectiveness of Pulsed and Continuous Diclofenac Phonophoresis in Treatment of Knee Osteoarthritis

“…The topical diclofenac solution was found to be significantly more effective than the other applications for the WOMAC pain, stiffness and physical function indices, and pain during activity as well as global patient assessment 13) . In a similar study by Baer et al 14) , patients with knee osteoarthritis were treated with topical diclofenac solution. Statistically significant improvements in WOMAC pain, stiffness and physical function, and patient global assessment scores were seen compared to a group treated with placebo.…”

Acute Pain Management in the Emergency Department

“…Topical diclofenac and ibuprofen have been shown to be effective in acute soft tissue injuries, such as ankle sprains as well as arthritic knee pain [68,72,73]. Furthermore, topical diclofenac has been shown to be effective in reducing myofascial pain, however, with no effect on the myofascial trigger point pain threshold [74].…”

Topical diclofenac: clinical effectiveness and current uses in osteoarthritis of the knee and soft tissue injuries

“…In these studies, minor skin dryness was a common complaint in 36-39% of patients. In 5-6% of patients skin dryness lead to discontinuation of treatment [42,46]. More serious gastrointestinal complaints were limited and cardiovascular side effects were not evaluated.…”

“…In RCTs involving patients with OA of the knee, 1.5% topical diclofenac induced a significant reduction in pain relief, morning stiffness and improvement in functional mobility and patient global assessment in patients in durations of 4 week [43], 6 week [42] and 12 week trials [46] compared to placebo. In these studies, minor skin dryness was a common complaint in 36-39% of patients.…”

“…Several studies have shown the therapeutic benefits of topical diclofenac and its role in pain management where sufficient concentrations of diclofenac is distributed to the target tissue and in so doing produces a therapeutic effect. There are currently a range of published studies, meta-analyses and systematic reviews, and working party recommendations that have explored the use of topical diclofenac as part of pain management for patients with OA of the knee [41][42][43][44][45][46][47], sports injury [19], soft tissue injury [36,[48][49][50], actinic ketatoses [51] and acute migraine attacks [52]. Key studies are identified in Table 1.for OA of the knee and Table 2 for sports injury studies and meta-analyses.…”