Effect of a topical diclofenac solution for relieving symptoms of primary osteoarthritis of the knee: a randomized controlled trial

Bookman, Arthur A. M.; Williams, Kate S. A.; Shainhouse, J. Zev
August 2004
CMAJ: Canadian Medical Association Journal;8/17/2004, Vol. 171 Issue 4, p333
Academic Journal
Background: Treatment of osteoarthritis with oral NSAID therapy provides pain relief but carries a substantial risk of adverse effects. Topical NSAID therapy offers an alternative to oral treatment, with the potential for a reduced risk of side effects. The objective of this trial was to assess the safety and efficacy of a topical diclofenac solution in relieving the symptoms of primary osteoarthritis of the knee. Methods: We identified 248 men and women from southern Ontario with primary osteoarthritis of the knee and at least moderate pain. The patients were randomly assigned to apply 1 of 3 solutions to their painful knee for 4 weeks: a topical diclofenac solution (1.5% wt/wt diclofenac sodium in a carrier containing dimethyl sulfoxide [DMSO]); a vehicle-control solution (the carrier containing DMSO but no diclofenac); and a placebo solution (a modified carrier with a token amount of DMSO for blinding purposes but no diclofenac). The primary efficacy end point was pain relief, measured by the Western Ontario and McMaster Universities (WOMAC) LK3.0 Osteoarthritis Index pain subscale. Secondary end points were improved physical function and reduced stiffness (measured by the WOMAC subscales), reduced pain on walking and patient global assessment (PGA). Safety was evaluated with clinical and laboratory assessments. Results: In the intent-to-treat group the mean change (and 95% confidence interval [CI]) in pain score from baseline to final assessment was significantly greater for the patients who applied the topical diclofenac solution (-3.9 [-4.8 to -2.9]) than for those who applied the vehicle-control solution (-2.5 [-3.3 to -1.7]; p= 0.023) or the placebo solution (-2.5 [-3.3 to -1.7]; p = 0.016). For the secondary variables the topical diclofenac solution also revealed superiority to the vehicle-control and placebo solutions, leading to mean changes (and 95% CIs) of -11.6 (-14.7 to -8.4; p = 0.002 and 0.014, respectively) in pain on walking. The ...


Related Articles

  • Diclofenac solution ( Pennsaid ) in the management of osteoarthritis of the knee; patient implications. Banning, Maggi // Journal of Chinese Clinical Medicine;2009, Vol. 4 Issue 6, p335 

    Topical diclofenac sodium ( pennsaid)is a non-steroidal-anti-inflammatory drug that is used to manage the recurrent pain and symptoms of osteoarthritis of the knee. Pennsaid is applied topically , absorbed cutaneously and concentrates locally at the site of application. Towheed , et al. has...

  • Guidelines for the non-surgical treatment of osteoarthritis of the hip and knee.  // Australian Journal of Pharmacy;Apr2011, Vol. 92 Issue 1091, p46 

    The article offers information on non-surgical treatment of osteoarthritis of the hip and knee. It is recommended that healthcare professionals should have proper assessment and management of nutrition and exercise lifestyle behavior change. Further, it discusses the pharmacological...

  • Diclofenac.  // AHFS Consumer Medication Information;Sep2017, p1 

    Diclofenac is used to relieve pain, tenderness, swelling, and stiffness caused by osteoarthritis (arthritis caused by a breakdown of the lining of the joints), rheumatoid arthritis (arthritis caused by swelling of the lining of the joints), and ankylosing spondylitis (arthritis that mainly...

  • Non-steroidal anti-inflammatory drugs, including cyclo-oxygenase-2 inhibitors, in osteoarthritic knee pain: meta-analysis of randomised placebo controlled trials.  // Journal of the American Chiropractic Association;Apr2005, Vol. 42 Issue 3, p14 

    This article presents information on a study conducted to estimate the analgesic efficacy of non-steroidal anti-inflammatory drugs (NSAIDs), including selective cyclo-oxygenase-2 inhibitors (coxibs), in patients with osteoarthritis of the knee. It is reported that there were 23 trials including...

  • Diclofenac Topical (osteoarthritis pain)  // AHFS Consumer Medication Information;Sep2017, p1 

    Diclofenac 1% topical gel is used to relieve pain from osteoarthritis (arthritis caused by a breakdown of the lining of the joints) in certain joints such as those of the knees, ankles, feet, elbows, wrists, and hands. Diclofenac 1% topical liquid is used to relieve osteoarthritis pain in the...

  • Glucosamine and chondroitin effective for knee osteoarthritis. Longyhore, Daniel S.; Seaton, Terry L. // Journal of Family Practice;Dec2003, Vol. 52 Issue 12, p919 

    This meta-analysis recommends that clinicians should consider glucosamine and chondroitin as viable first-line treatment options to reduce the symptoms of knee osteoarthritis. These agents are especially useful for patients who cannot tolerate non-steroidal anti-inflammatory drugs (NSAIDs or for...

  • Acetaminophen Versus NSAIDs. Sorbie, Charles // Orthopedics;Apr2004, Vol. 27 Issue 4, p369 

    Reports on a study that reviewed the evidence and guidelines for prescribing acetaminophen or nonsteroidal anti-inflammatory drugs (NSAID) for hip or knee osteoarthritis treatment. Comparison between acetaminophen and NSAID; Conclusion of the study.

  • NSAIDs and hypertension. Albishri, Jamal // Anaesthesia, Pain & Intensive Care;May-Aug2013, Vol. 17 Issue 2, p171 

    Non-steroidal anti-inflammatory drugs (NSAIDs) are frequently used to alleviate pain of the patients suffering from inflammatory conditions such as osteoarthritis, rheumatoid arthritis, and other painful conditions. An ample amount of studies put forth evidence that NSAIDs reduce the efficiency...

  • Controversies in the treatment of osteoarthritis. Bird, H. A. // Clinical Rheumatology;Sep2003, Vol. 22 Issue 3, p165 

    Discusses issues and controversies surrounding the treatment of osteoarthritis. Problems in developing treatment for osteoarthritis; Slow progression of the disease; Treatment options including physiotherapy, analgesics and non-steroidal anti-inflammatory drugs.


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics