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

Abstract

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.

Uji Aktivitas Antiinflamasi Salep Ekstrak Daun Cengkeh (Syzygium aromaticum)

“…Bentuk topikal yang sering digunakan antara lain salep, krim maupun gel. Beberapa penelitian menyebutkan bahwa bentuk topikal sama efektifnya dengan sediaan oral untuk mengatasi inflamasi dengan resiko terjadinya ADR lebih rendah (Klinge & Sawyer, 2013;Rannou et al, 2016;Wang et al, 2022).…”

Changing Stimulation Frequency Improves Implanted Peripheral Nerve Stimulator Effects Following Post-Traumatic Total Hip Arthroplasty: A Case Report

“…3 Pharmaceutical management with oral NSAIDs is often a first line therapy. 4 Intra-articular glucocorticoid injection has been shown to have a better short-term benefit (4 wks), with hyaluronic acid having superior benefit long term (26 wks). 5 Persistent pain and severe functional restrictions resistant to conservative management are frequent indications for invasive treatments including total hip replacement (THA).…”

“…Pharmaceutical management with oral Non-steroidal-anti-inflammatory-drug (NSAIDs) are strongly recommended, as they are the mainstay for symptom relief of osteoarthritis 3 . Pharmaceutical management with oral NSAIDs is often a first line therapy 4 . Intra-articular glucocorticoid injection has been shown to have a better short-term benefit (4 wks), with hyaluronic acid having superior benefit long term (26 wks) 5 .…”

Are topical NSAIDs as effective as oral NSAIDs for treatment of osteoarthritis pain in adults?

“…A 2022 meta-analysis of eight randomized controlled trials (RCTs) (N52,096) evaluated the efficacy and safety of topical and oral non-steroidal antiinflammatory drugs (NSAIDs). 1 Patients were 40 years old and older, with roughly two-thirds being female. Patients were included if they had radiological evidence for osteoarthritis (OA), had a history of moderate pain for at least one month, and morning stiffness for at least 30 minutes.…”