Topical diclofenac for the treatment of the musculoskeletal diseases

Имаметдинова, Г. Р.; Иголкина, Е. В.

doi:10.21518/2079-701x-2018-12-98-104

Med. sov.

2018

DOI: 10.21518/2079-701x-2018-12-98-104

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Topical diclofenac for the treatment of the musculoskeletal diseases

Г. Р. Имаметдинова¹,

Е. В. Иголкина²

Abstract: Лечение заболеваний опорно-двигательного аппарата до настоящего времени остается не только серьезной медицинской, но и социально-экономической проблемой. Хронические заболевания суставов и позвоночника являются одной из наи-более частых причин инвалидизации пациентов. Основными клиническими проявлениями большинства заболеваний опорно-двигательного аппарата являются боль и воспаление, что требует проведения адекватной противовоспалительной терапии. Представлены данные о многообразных механизмах действия нестеро… Show more

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2021

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Cited by 2 publications

References 37 publications

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Back pain

Пизова

2021

Medicinskij sovet

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Low back pain is a major cause of disability worldwide. Data on the prevalence of low back pain are presented. Information on the pathogenesis of pain is given. The temporal characteristics of pain are presented. Risk factors and triggers for episodes of low back pain are reviewed. The most common causes of specific and non-specific low back pain are described. Non-specific low back pain is more common, as no specific pathological-anatomical cause can be identified. Specific pain includes nociceptive and neuropathic pain. In order to make a correct diagnosis in a patient with low back pain, a thorough medical history must be taken, which usually provides important information in identifying the cause of the pain syndrome. The warning signs (‘red flags’) for specific causes of low back pain requiring urgent treatment and specific psychosocial factors contributing to chronic pain (‘yellow flags’) are considered separately. ‘Red flags’ include conditions such as suspected traumatic injury, tumour, infection or radiculopathy and cauda equina syndrome. «Yellow flags» include individual cognitive, emotional and behavioural factors that contribute to the development of chronic pain. The main aim of pharmacotherapy for low back pain is to enable patients to continue or resume their normal daily activities. The main recommended approaches in the treatment of acute and chronic low back pain are presented. The main non-steroidal anti-inflammatory drugs for the oral drug treatment of non-specific low back pain are described, with evidence-based doses. Special attention is given to the role of diclofenac in the treatment of pain. The authors present the results of systematic reviews that analyse the available data on the efficacy and safety of topical transdermal dosage forms that contain NSAIDs.

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Back pain

Пизова

2021

Medicinskij sovet

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Local anti-inflammatory therapy for osteoarthritis with high comorbidity

2021

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Osteoarthritis (OA) is a widespread disease, the leading symptom of which is pain in the load-bearing joints, and the incidence increases with age. Many patients with OA have several comorbidities, such as arterial hypertension, coronary heart disease, diabetes mellitus, gastric and duodenal ulcers. Currently, there are different approaches to the treatment of OA with and without comorbidity. In particular, oral non-steroidal anti-inflammatory drugs (NSAIDs) are not recommended for OA with high comorbidity. The literature review discusses the prospects and popularity of the use of local forms of NSAIDs associated with their equal analgesic efficacy relative to oral drugs, but with a smaller number of adverse events. Data on transcutaneous forms of diclofenac are analyzed, which can provide at least oral equivalent analgesia, improved physical function and reduced stiffness in osteoarthritis of the hands and knee joints, while showing fewer systemic adverse events. This feature of topical NSAIDs allows them to be considered as an effective first-line treatment option, especially in elderly patients and those with severe comorbidity. Topical medications containing diclofenac as the main active ingredient are popular among both patients and doctors, and their use has an extensive evidence base. Diclofenac ethylenediamine salt has advantages over sodium salt in its penetrating properties, and the form of an emulsion gel containing a hydrophobic phase that slows down the drying of the substance applied to the skin provides ease of use and improves the consumer properties of agents for local antiinflammatory therapy of osteoarthritis.

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Topical diclofenac for the treatment of the musculoskeletal diseases

Cited by 2 publications

References 37 publications

Back pain

Back pain

Local anti-inflammatory therapy for osteoarthritis with high comorbidity

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