Efficacy and Safety of Oral Diclofenac Sustained release Versus Transdermal Diclofenac Patch in Chronic Musculoskeletal Pain: A Randomized, Open Label Trial

Shinde, Viraj Ashok; Kalikar, Mrunalini; Jagtap, Satyajeet; Dakhale, Ganesh N.; Bankar, Mangesh; Bajait, Chaitali S; Motghare, Vijay M.; Pashilkar, Ashlesha A; Raghute, Latesh; Khamkar, Ajita D

doi:10.4103/jpp.jpp_35_17

Cited by 8 publications

(9 citation statements)

References 19 publications

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“…He stated that it may be attributed secondary to the extraction procedure as majority of the patients tolerated the patch well with uneventful post-operative period. Shinde et al 7 reported with local irritation over the right arm in 16% of patients and 4% patients had burning sensation in abdomen in transdermal patch group. From the observations of our study, diclofenac transdermal patch is found to be the most potent and efficacious routes of drug delivery systems in reduction of all three parameters of pain, swelling and trismus without any adverse events when compared to oral diclofenac postoperatively after mandibular third molar surgery.…”

Section: Discussionmentioning

confidence: 92%

Comparing the analgesic safety and efficacy of Diclofenac sodium tablet vs transdermal Diclofenac on postoperative third molar Extraction pain, swelling and trismus

Dastagir¹,

Balamurugan²

2019

J Dentomaxillofac Sci

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Objective: To compare the analgesic efficacy of oral diclofenac sodium to diclofenac sodium transdermal patch in the management of postoperative pain, swelling and trismus following surgical removal of impacted mandibular third molars. Material and Methods: The total of 100 patients were randomly assigned to one of the two groups. Group I patients were medicated with oral diclofenac sodium 50 mg thrice daily for 3days. Group II patients had transdermal diclofenac sodium patches 100 mg placed once daily for 3 days after mandibular third molar surgery. All the patients were assessed for pain using a visual analogue scale, swelling with three point discrimination and trismus by measuring the inter-incisal distance on 2nd and 7th postoperatively days. analogue scale, swelling with three point discrimination and trismus by measuring the inter-incisal distance on 2nd and 7th postoperatively days. Results: Patients in group II had less pain, swelling and trismus when compared with group I on 2nd and 7th postoperative days with statistical significance of p<0.05 respectively. Conclusion: Transdermal diclofenac patches provide an effective way in management of postoperative pain, swelling and trismus in patients of mandibular impactions with negligible side effects and good patient compliance.

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Section: Discussionmentioning

confidence: 92%

Comparing the analgesic safety and efficacy of Diclofenac sodium tablet vs transdermal Diclofenac on postoperative third molar Extraction pain, swelling and trismus

Dastagir¹,

Balamurugan²

2019

J Dentomaxillofac Sci

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“…A 2016 Cochrane systematic review on topical NSAIDs for chronic musculoskeletal pain was included [ 16 ]. This review was updated with an additional 42 studies: 14 compared to placebo [ 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 ], four compared to oral NSAIDs [ 84 , 85 , 86 , 87 ], five compared to topical NSAIDs [ 88 , 89 , 90 , 91 , 92 ], and 19 compared to other topical drugs [ 93 , 94 , 95 , 96 , 97 , 98 , 99 , 100 , 101 , 102 , 103 , 104 , 105 , 106 , 107 , 108 , 109 , 110 , 111 ].…”

Section: Resultsmentioning

confidence: 99%

Multidisciplinary Guidelines for the Rational Use of Topical Non-Steroidal Anti-Inflammatory Drugs for Musculoskeletal Pain (2022)

Shi

Shao

et al. 2023

JCM

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(1) Background: Topical non-steroidal anti-inflammatory drugs (NSAIDs) are one of the primary drugs for treating musculoskeletal pain. However, there are currently no evidence-based recommendations about drug selection, drug administration, drug interactions, and use in special populations or other pharmacology-related content of such medications. To this end, the Chinese Pharmaceutical Association Hospital Pharmacy Professional Committee developed multidisciplinary guidelines on using topical NSAIDs to treat musculoskeletal pain. (2) Methods: The guidelines development process followed the World Health Organization guideline development handbook, the GRADE methodology, and the statement of Reporting Items for Practice Guidelines in Healthcare. The guideline panel used the Delphi method to identify six clinical questions to be addressed in the guidelines. An independent systematic review team conducted a systematic search and integration of evidence. (3) Results: Based on the balance between the benefits and harms of an intervention, the quality of the evidence, patient preferences and values, and resource utilization, the guideline panel developed 11 recommendations and nine expert consensuses on using topical NSAIDs to treat acute and chronic musculoskeletal pain. (4) Conclusions: Based on the effectiveness and overall safety of topical NSAIDs, we recommend patients with musculoskeletal pain use topical NSAIDs and suggest high-risk patients use topical NSAIDs, such as those with other diseases or receiving other concurrent treatments. The evidenced-based guidelines on topical NSAIDs for musculoskeletal pain incorporated a pharmacist perspective. The guidelines have the potential to facilitate the rational use of topical NSAIDs. The guideline panel will monitor the relevant evidence and update the recommendations accordingly.

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“…We first removed any duplicate articles, leaving us with 408 qualified articles which were then further reduced to 23 for further evaluation following detailed examination of their titles and abstracts. These 23 were then further reduced to only 8 articles describing RCTs [12][13][14][15][16][17][18][19] fulfilling all of our eligibility criteria for inclusion. A flowchart describing these selections and our exclusion criteria is shown in Figure 1.…”

Section: Search Resultsmentioning

confidence: 99%

“…The characteristics of the included studies are summarized in Table 2 and can be described as follows: Our 8 RCTs [12][13][14][15][16][17][18][19] included the data from 2096 patients with OA of which 1083 were treated with topical NSAIDs and 1103 were treated with oral NSAIDs. Of these only 6 study participants were aged ≥50 years and 9 studies reported 34 cases (1.6%) of follow-up loss: 14 from the topical group (n = 14, 1.3%) and 20 from the oral group (n = 20, 1.9%).…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

“…Of these only 6 study participants were aged ≥50 years and 9 studies reported 34 cases (1.6%) of follow-up loss: 14 from the topical group (n = 14, 1.3%) and 20 from the oral group (n = 20, 1.9%). Three trials compared oral and topical diclofenac, [13,16,17] 2 trials compared topical ketoprofen and oral celecoxib, [12,14] and 1 trial compared topical and oral ibuprofen. [15] The remaining 2 items described evaluations of oral diclofenac and eltenac gel, [18,19] gypsum NSAIDs, and oral NSAIDs, respectively.…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

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Relative safety and efficacy of topical and oral NSAIDs in the treatment of osteoarthritis: A systematic review and meta-analysis

et al. 2022

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Background: Osteoarthritis (OA) often affects the hands, knees, and hip joints, causing considerable pain and disability, and often affecting the patient's quality of life. Non-steroidal anti-inflammatory drugs (NSAIDs) are common pain relievers often applied as first line therapies for OA. However, prolonged NSAIDs application can have unwanted side effects. Given this, this study was designed to systematically evaluate the efficacy and safety of topical and oral NSAIDs for the treatment of OA.Methods: We searched the PubMed, Embase, Cochrane Library, and Web of Science databases for relevant papers from their inception dates to May 2021. Our study only included randomized controlled trials comparing topical and oral NSAIDs and all data were analyzed using Review Manager version 5.3 (RevMan version 5.3).Results: We identified 8 RCTs (2096 patients with OA), for evaluation and revealed that, in general, topical and oral NSAIDs presented with similar efficacies for the treatment of OA. The Western Ontario and McMaster Osteoarthritis Index for assessing pain relief in OA patients was (standardized mean difference [SMD] 0.07; 95%CI −0.02, 0.17) and visual analog scale was (SMD −0.01; 95%CI −0.02, 0.18), and improved stiffness in OA patients (SMD 0.09; 95%Cl 0.03, 0.20).Conclusions: Topical NSAIDs are as effective as oral NSAIDs for the treatment of OA and both topical and oral NSAIDs are equally effective in reducing pain and improving physical function in OA patients. In terms of safety, a larger number of samples are still needed to determine if there are any differences in the safety profile of topical or oral NSAIDs.

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Efficacy and Safety of Oral Diclofenac Sustained release Versus Transdermal Diclofenac Patch in Chronic Musculoskeletal Pain: A Randomized, Open Label Trial

Cited by 8 publications

References 19 publications

Comparing the analgesic safety and efficacy of Diclofenac sodium tablet vs transdermal Diclofenac on postoperative third molar Extraction pain, swelling and trismus

Comparing the analgesic safety and efficacy of Diclofenac sodium tablet vs transdermal Diclofenac on postoperative third molar Extraction pain, swelling and trismus

Multidisciplinary Guidelines for the Rational Use of Topical Non-Steroidal Anti-Inflammatory Drugs for Musculoskeletal Pain (2022)

Relative safety and efficacy of topical and oral NSAIDs in the treatment of osteoarthritis: A systematic review and meta-analysis

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