Topical diclofenac 'deserves further consideration' for knee OA

A meta-analysis has concluded that topical diclofenac "deserves further consideration" when the existing treatment guidelines for OA of the knee are updated.Dr Tanveer Towheed (Queen's University, Ontario) conducted a review of published randomised controlled trials to evaluate the efficacy of a new topical diclofenac solution (Pennsaid®) in patients with osteoarthritis (OA) of the knee.The meta-analysis evaluated study demographics, methodology, quality, and outcomes. Overall, three published reports and one published abstract of trials were included, encompassing more than 1400 patients. Study duration ranged from four to 12 weeks (mean 5.8 weeks).Compared with placebo the diclofenac solution was reported to be superior for WOMAC pain, stiffness, and physical function subscales, as well as for patient assessment; however, the active solution more likely to cause minor skin dryness at the site of application.Towheed's review also refers to a 12-week equivalence trial that used the WOMAC subscales to compare treatment response with oral diclofenac. In this study the diclofenac solution was as effective as oral therapy, but better tolerated.In concluding Dr Towheed comments that the diclofenac solution is "an effective topical NSAID in patients with OA of the knee." However, the author adds that it is not known whether similar benefits can be produced with other topical NSAIDs.Reference...