Topical nonsteroidal anti-inflammatory drugs for the treatment of pain due to soft tissue injury: diclofenac epolamine topical patch

Abstract

The objective of this article is to review published clinical data on diclofenac epolamine topical patch 1.3% (DETP) in the treatment of acute soft tissue injuries, such as strains, sprains, and contusions. Review of published literature on topical nonsteroidal anti-inflammatory drugs (NSAIDs), diclofenac, and DETP in patients with acute soft tissue injuries was included. Relevant literature was identified on MEDLINE using the search terms topical NSAIDs, diclofenac, diclofenac epolamine, acute pain, sports injury, soft tissue injury, strain, sprain, and contusion, and from citations in retrieved articles covering the years 1978–2008. Review of published, randomized clinical trials and meta-analyses shows that topical NSAIDs are significantly more effective than placebo in relieving acute pain; the pooled average relative benefit was 1.7 (95% confidence interval, 1.5–1.9). In a limited number of comparisons, topical and oral NSAIDs provided comparable pain relief, but the use of topical agents produced lower plasma drug concentrations and fewer systemic adverse events (AEs). The physical–chemical properties of diclofenac epolamine make it well suited for topical use. In patients with acute soft tissue injuries treated with DETP, clinical data report an analgesic benefit within hours of the first application, and significant pain relief relative to placebo within 3 days. Moreover, DETP displayed tolerability comparable with placebo; the most common AEs were pruritus and other application site reactions. Review of published literature suggests that DETP is generally safe and well tolerated, clinically efficacious, and a rational treatment option for patients experiencing acute pain associated with strains, sprains, and contusions, and other localized painful conditions.

Inhibition of Wound TGF Beta-1 by Celecoxib: A Possible Therapeutic Route for Scar Free Wound

“…Additionally, the response to COX inhibition varied in different species, while COX inhibitors did not affect wound healing in hairless SKH-1 mice, they delayed healing in C57BL/6J mouse [83] and this could be explained by differences in genetic background [86] between species and even intra-species. Furthermore, the route of administration of the drugs would another factor explaining the discrepancy in the results; oral administration of COX inhibitor were found not to improve healing [82,83], indeed topical application would be more effective in wound healing than systemic [87,88].…”

Formulation and evaluation of mefenamic acid emulgel for topical delivery

“…There is no marketed topical formulation of mefenamic acid available till date. Most of the topical preparations are used for the localized effects at the site of their application by virtue of drug penetration into the underlying layers of skin or mucous membranes (Lionberger and Brennan, 2010). Although some unintended drug absorption may occur, it is of sub therapeutic quantities and generally of minor concern.…”

Skin permeability and pharmacokinetics of diclofenac epolamine administered by dermal patch in Yorkshire-Landrace pigs

“…The diclofenac epolamine topical patch was found to be more effective than placebo in treating strains, sprains, and contusions,4,7,8 and symptoms of primary osteoarthritis of the knee 2. Diclofenac epolamine topical patch was also shown to be either superior or equivalent to oral diclofenac formulations or placebo for use in osteoarthritis of the knee and soft-tissue injuries 9.…”