Abstract
Non steroidal Anti- inflammatory drugs have their origin as the derivatives of plants, which were observed to have their therapeutic effects in different disease states. They have the advantage of local action without developing central adverse effects and cognitive impairments. Side effects have been well described, although partly neglected. Topical delivery of NSAID has its therapeutic applications in management of pain and inflammation in Rheumatoid arthritis patients. Rheumatoid arthritis is a chronic systemic inflammatory disorder that may affect many tissues and organs but principally attacks the synovial joints. It can be disabling and painful condition, which can lead to substantial loss of functioning and mobility if not adequately treated. The aim of the present investigation was to compare the Ketoprofen cream with Diclofenac and Piroxicam cream in a group of volunteers suffered from Rheumatoid arthritis and to compare the efficacy of these creams in reduction of inflammation. This single blind comparative study was done to determine the efficacy, tolerability and acceptability of topical application of Ketoprofen cream (1%w/w) vs diclofenac cream (1%w/w) and piroxicam cream (0.5%w/w) in Rheumatoid arthritis patients. In this study, one hundred and twenty five volunteers suffering with acute Rheumatoid arthritis and age group between 40-70 years were analyzed for assessing the intensity of pain and anti-inflammatory effects of these three creams. The study revealed that Ketoprofen cream provides a good level of pain relief removes swelling and tenderness and improves the functional impairment, without the systemic adverse events associated with oral NSAIDs. Key Words: Cream, Diclofenac, Ketoprofen, Piroxicam, Rheumatoid arthritis
Highlights
Rheumatoid arthritis is an autoimmune progressive disorder that leads to the destruction of cartridge, bone and ligaments causing deformity of joints (Wolfe and Hawley 1998)
One hundred and twenty five volunteers were divided into three groups receiving ketoprofen cream, diclofenac cream and/or piroxicam cream
The volunteers were given written instructions to apply the cream regularly on affected area in a dose of 4 inches [3,4] times a day up to 14 days. Volunteers both between the ages of [40-70] suffered from acute rheumatoid arthritis were included in this study
Summary
Rheumatoid arthritis is an autoimmune progressive disorder that leads to the destruction of cartridge, bone and ligaments causing deformity of joints (Wolfe and Hawley 1998). Non-steroidal anti-inflammatory drugs (NSAIDs) are widely used to relieve pain and inflammation in rheumatoid arthritis patients, but their use comes at the cost of toxicity, with a 2-4%. Ketoprofen, diclofenac and piroxicam are the drugs included in the class of non-steroidal anti-inflammatory drugs (NSAIDs), each drug has a specific tissue distribution and pharmacodynamics (Rainsford et al, 2008). They block the inflammatory cascade and cycloxygenases (COX) by inhibiting prostaglandin and thromboxane. Ketoprofen Cream Vs Diclofenac and Piroxicam Cream production and lead to reduction in pain, fever, platelet aggregation and inflammatory response (Rao, 2008). The use of oral preparations of NSAIDs increase the risk of gastrointestinal and cardiovascular complications compared with non NSAIDs users (Aronson, 2005). The UK NICE guidelines for knee and hand osteoarthritis recommend use of paracetamol and/or topical NSAIDs over oral NSAIDs, COX2 inhibitors, and opioids (Conaghan, et al, 2008)
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