Friday, March 28, 2014

Topical NSAIDs May Be a Better Choice for Elderly With OA

September 18, 2012 — Topical diclofenac is about as effective as oral diclofenac in knee and hand osteoarthritis OA, is probably as effective as other oral NSAIDs, and might be a safer choice for elderly patients and others at risk for gastrointestinal adverse effects, according to an intervention review published online September 12 in the Cochrane Database of Systematic Reviews.Sheena Derry, PhD, and colleagues from the University of Oxford in the United Kingdom based their conclusions about topical NSAIDs on a review of randomized, double-blind studies with placebo or active comparators in which at least a single treatment was a topical NSAID used to treat chronic pain caused by OA, and in which treatment lasted at least 2 weeks. The analysis included data from 7688 participants in 34 studies, 23 of which compared a topical NSAID with placebo."Topical NSAIDs were significantly more effective than placebo for reducing pain due to chronic musculoskeletal conditions," the authors conclude. "Direct comparison of topical NSAID with an oral NSAID did not show any difference in efficacy." Topical NSAIDs were associated with more local adverse events, such as mild rash, but with fewer gastrointestinal adverse events than oral NSAIDs.

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