Topical Diclofenac Solution for Osteoarthritis of the Knee: An Updated Meta-Analysis of Randomized Controlled Trials.

Tao Ling,Wei-Hong Ge,Jiao Jiao Li,Rui-Juan Xu,Bin Wang

doi:10.1155/2020/1758071

Abstract

This study was performed to assess the efficacy and safety of a topical diclofenac solution in patients with knee osteoarthritis (OA). PubMed, Embase, Cochrane Library, Web of Science, and Scopus databases were searched for randomized controlled trials until June 2020. The WOMAC pain, stiffness, physical function subscales, pain on walking, and the occurrence of adverse events were pooled to comprehensively analyse the efficacy and safety of topical diclofenac solution. All statistical analyses were conducted using Review Manager 5.3 software. Five RCTs were included, which provided high-quality evidence. In comparison to the vehicle control, the mean differences for WOMAC pain, stiffness, and physical function subscales, as well as pain on walking, were all statistically significant in favor of topical diclofenac solution. The safety of topical diclofenac solution was similar to the vehicle control, apart from adverse events involving application-site skin reactions. Topical diclofenac solution is effective and safe for use in patients with knee OA, but may cause minor skin reactions.

Highlights

Osteoarthritis (OA) is a highly prevalent degenerative joint disease, which can cause chronic pain and disability that significantly affect quality of life and the ability to perform daily activities
Topical nonsteroidal anti-inflammatory drugs (NSAIDs) are strongly recommended for knee OA patients with no comorbidities, which have shown modest benefits over a course of 12 weeks according to high-quality evidence [16]
Topical NSAIDs are strongly recommended for knee OA patients with gastrointestinal or cardiovascular comorbidities, as well as for patients with frailty

Summary

Introduction

Osteoarthritis (OA) is a highly prevalent degenerative joint disease, which can cause chronic pain and disability that significantly affect quality of life and the ability to perform daily activities. Chronic OA management creates severe burdens for global healthcare systems and negative impacts on work productivity [2,3,4,5]. Depending on the stage of disease, treatment may range from conservative approaches to surgery for removing the joint. Current conservative management approaches for knee OA include extracorporeal shock wave [6], chondroitin sulfate [7], hyaluronic acid [8], and nonsteroidal anti-inflammatory drugs (NSAIDs) [9, 10]. Various complementary treatments have been tested including acupuncture [11], Baduanjin exercises [12, 13], and herbal medicines [14, 15]

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