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Drug Evaluation

Topical diclofenac: clinical effectiveness and current uses in osteoarthritis of the knee and soft tissue injuries

, EdD MSc PGDE BSc
Pages 2921-2929 | Published online: 20 Oct 2008

Bibliography

  • Bridgman SA, Clement D, Downing A. Population based epidemiology of ankle sprains attending accident and emergency units in the West Midlands of England, and a survey of UK practice for severe ankle sprains. Emerg Med J 2003;20:508-10
  • Lawrence RC, Hochberg MC, Kelsey JL, et al. Estimates of the prevalence of selected arthritic and musculoskeletal diseases in the US. J Rheumatol 1989;16:427-41
  • Felson DT, Lawrence RC, Dieppe RA, et al. Osteoarthritis: new insights Part 1: the disease and risk factors. Ann Intern Med 2000;43:635-46
  • Arden N, Newitt MC. Osteoarthritis epidemiology. Best Pract Res Clin Rheumatol 2006;20:3-25
  • Felson DT, Zhang Y. An update on the epidemiology of knee and hip osteoarthritis with a view to prevention. Arthritis Rheum 1998;41:1343-55
  • Woolf AD, Pfleger B. Burden of major musculoskeletal conditions. Bull World Health Organ 2003;81:646-56
  • Manek NJ, Lane NE. Osteoarthritis: current concepts in diagnosis and management. Am Acad Fam Physician 2000;61:1795-804
  • Kidd BL, Urban LA, Hui X, et al. In vivo bioavailability and metabolism of topical diclofenac lotion in human volunteers. Pharm Res 1998;15:1589-95
  • Altman R, Asch E, Bloch D, et al. Development of criteria for the classification and reporting of osteoarthritis. Classification of osteoarthritis of the knee. Arthritis Rheum 1991;29:1039-49
  • Moskowitz EW, Holderbaum D. Clinical and laboratory findings in osteoarthritis. In: Koopman WJ, editor, Arthrititis and allied conditions. 14th edition. Philadelphia: Lippincott, Willaims & Wilkins; 2001. p. 2216-43
  • Barron MC, Rubin BR. Managing osteoarthritic knee pain. JAOA 2007;6:ES21-7
  • Felson DT, Chaisson CE, Hill CL. The association of bone marrow lesions with pain in knee osteoarthritis. Ann Intern Med 2001;134:541-9
  • Hill CL, Gale DR, Chaisson CE. Knee effusions, popliteal cysts, and synovial thickening: association with knee pain in osteoarthritis. J Rheumatol 2001;28:1330-8
  • Pelletier JP, DiBattista JA, Roughley P, et al. Cytokines and inflammation in cartilage degradation. Rheum Dis Clin North Am 1993;19:545-68
  • Malemud CJ. The role of growth factors in cartilage metabolism. Rheum Dis Clin North Am 1993;19:569-80
  • Galeazzi M, Marcolongo R. A placebo-controlled study of the efficacy and tolerability of a nonsteroidal anti-inflammatory drug. DHEP plaster, in inflammatory, peri and extra-articular rheumatological diseases. Drugs Exp Clin Res 1993;19:117-27
  • Moore RA, Tramer MR, Carroll D. Quantitive systematic review of topically applied non-steroidal anti-inflammatory drugs. BMJ 1998;16:333-6
  • Vaile JH, Davis P. Topical NSAIDs for musculoskeletal conditions. A review of the literature. Drugs 1998;56:783-99
  • Galer BS, Rowbotham M, Perander J, et al. Topical diclofenac patch relieves minor sports injury pain: results of a multicenter controlled clinical trial. J Pain Symptom Manage 2000;19:287-94
  • Roth SH. A controlled clinical trial of 3% diclofenac/2.5% sodium hyaluronate topical gel in the treatment of uncontrolled pain in chronic NSAID users with osteoarthritis. Int J Tissue React 1995;17:129-32
  • Sandelin J, Harilainen A, Crone H. Local NSAID gel (eltenacP) in the treatment of osteoarthritis of the knee: a double blind study comparing eltenac with oral diclofenac and placebo gel. Scand J Rheumatol 1997;26:287-92
  • Brooks PM, Day RO. Nonsteroidal anti-inflammatory drugs: differences and similarities. N Engl J Med 1991;324:1716-25
  • Cramer MP, Saks SR. Translating safety, efficacy and compliance into economic value for controlled release dosage forms. Pharmacoeconomics 1994;70:482-504
  • Stanos SP. Topical agents for the management of muscloskeletal pain. J Pain Symptom Manage 2007;33:342-55
  • Hewitt PG, Poblete N, Wester RC, et al. In vitro cutaneous disposition of a topical diclofenac solution in human skin: effect of a multi-dose regimen. Pharm Res 1998;15:988-92
  • Conte A, Ronca G, Petrini M, Mautone G. Effect of lecithin on epicutaneous adsorption of diclofenac epolamine. Drugs Exp Clin Res 2002;28:249-55
  • Spacca G, Cacchio A, Forgacs A, et al. Analgesic efficacy of a lecithin-vehiculated diclofenac epolamine gel in shoulder periarthritis and lateral epicondylitis: a placebo-controlled multicenter, randomized, double-blind clinical trial. Drugs Exp Clin Res 2005;31:147-54
  • Brühlmann P, De Vathaire F, Dreiser R, Beat M. Short-term treatment with topical diclofenac epolamine plaster in patients with symptomatic knee osteoarthritis: pooled analysis of two randomized clinical studies. Curr Med Res Opin 2006;22:2429-38
  • Davies NM, Anderson KE. Clinical pharmacokinetics of diclofenac. Clin Pharmacokinet 1997;33:184-213
  • Giachetti C, Assandri A, Mautone G. Pharmacokinetics and metabolism of N-(2-hydroxyethyl)-2,5-[14C]- pyrrolidine (HEP, Epolamine ) in male healthy volunteers. Eur J Drug Metab Pharmacokinet 1996;1:261-8
  • Gallacchi G, Marcolongo R. Pharmacokinetics of diclofenac hydroxyethylpyrrolidine (DHEP) plasters in patients with monolateral knee joint effusion. Drugs Exp Clin Res 1993;19:95-103
  • Assandri A, Canali S, Giachetti C. Local tolerability and pharmacokinetic profile of a new transdermal delivery DHEP plaster. Drugs Exp Clin Res 1993;19:89-96
  • Affaitati G, Vecchiet F, Lerza R. Effects of topical diclofenac (DHEP plaster) on skin, subcutis and muscle pain thresholds in subjects without spontaneous pain. Drugs Exp Clin Res 2001;27:69-76
  • Brooks PM. NSAIDs. In: Klippel JH, Dieppe PA, editors, Rheumatology. London: Mosby; 1994. p. 8-10
  • Benson MD, Aldo-Benson M, Brandt KD. Synovial fluid concentrations of diclofenac in patients with rheumatoid arthritis and osteoarthritis. Semin Arthritis Rheum 1985;1:65-7
  • Rusca A, Mautone G, Sun S, et al. Comparison of plasma pharmacokinetics of FLECTOR Patch (diclofenac epolamine topical patch) and oral volateren (diclofenac sodium enteric-coated tablets) in healthy volunteers. J Pain 2008;9(Suppl 1):45
  • Muller M, Rastelli C, Ferri P. Transdermal penetration of diclofenac after multiple epicutaneous administration. J Rheumatol 1998;9:1833-6
  • Singh P, Robert MS. Skin permeability and local tissue concentrations of nonsteroidal anti-inflammatory drugs after topical application. J Pharm Exp Ther 1994;268:144-51
  • Zacher J, Altman R, Bellamy N, et al. Topical diclofenac and its role in pain and inflammation: an evidence-based review. Curr Med Res Opin 2008;24:925-50
  • Grace D, Rogers J, Skeith K, Anderson K. Topical diclofenac versus placebo: a double-blind, randomized clinical trial in patients with osteoarthritis of the knee. J Rheumatol 1999;26:2659-63
  • Towheed TE. Pennsaid® therapy for osteoarthritis of the knee: a systematic review and meta-analysis of randomized controlled trials. J Rheumatol 2006;33:567-73
  • Baer PA, Thomas LM, Shainhouse JZ. Treatment of osteoarthritis of the knee with a topical diclofenac solution: a randomized controlled, 6-week trial [ISRCTN53366886]. BMC Musculoskelet Disord 2005;6:44-53
  • Bookman ARM, Williams KSA, Shainhouse JZ. Effect of a topical diclofenac solution for relieving symptoms of primary osteoarthritis of the knee: a randomized controlled trial. CMAJ 2004;171:333-8
  • Jordan KM, Arden NK, Doherty M, et al. EULAR recommendations 2003: an evidence based approach to the management of knee osteoarthritis: report of a task force of the standing committee for international clinical studies including therapeutic trials (ESCISIT). Ann Rheum Dis 2003;62:1145-55
  • Lin J, Zhang A, Jones A, Doherty M. Efficacy of topical non-steroidal anti-inflammatory drugs in the treatment of osteoarthritis; meta analysis of randomized controlled trials. BMJ 2004;329:324-9
  • Roth SF, Shainhouse JZ. Efficacy and safety of a topical diclofenac solution (Pennsaid) in the treatment of primary osteoarthritis of the knee. A randomized, double-blind, vehicle-controlled clinical trial. Arch Intern Med 2004;164:2017-23
  • Tugwell PS, Wells GA, Shainhouse JZ. Equivalence study of a topical diclofenac solution (Pennsaid®) compared with oral diclofenac in symptomatic treatment of osteoarthritis of the knee: a randomized controlled trial. J Rheumatol 2004;31:202-12
  • Belcaro B, Cesarone MR, Vinciguerra G, et al. A plaster combining diclofenac and heparin: microcirculatory evaluation in 2 models of high perfusion microangiopathy. Angiology 2005;56:707-13
  • Carr W, Beks P, Jones C, et al. Efficacy and tolerability of FLECTOR Patch (diclofenac epolamine topical patch) in the treatment of minor soft tissue injury pain. J Pain 2008;9:45-52
  • Predel HG, Koll R, Pabst H, et al. Diclofenac patch for topical treatment of acute impact injuiries: a randomized, double blind, placebo controlled, multicentre study. Br J Sports Med 2004;38:318-23
  • Ulrich C, Hackethal M, Ulrich M, et al. Treatment of multiple actinic keratoses with topical diclofenac 3% gel in organ transplant recipients: a series of six cases. Br J Dermatol 2007;156:40-2
  • Vécsei L, Gallacchi G, Sagi I, et al. Diclofenac epolamine is effective in the treatment of acute, migraine attacks. A randomized, crossover, double blind, placebo-controlled, clinical trial. Cephalgia 2007;27:29-34
  • Zhang LJ, Jones W, Doherty M. Efficacy of topical non-steroidal anti-inflammatory drugs in the treatment of osteoarthritis: meta-analysis of randomized controlled trials. BMJ 2004;324-6
  • Solignac M. Proof of the pharmacodynamic activity of Flector Plaster in healthy volunteers and patients suffering from osteo-arthritis of the knee. Presse Med 2004;33(Suppl 3):S5-9
  • Schapira D, Linn S, Scharf Y. A placebo-controlled evaluation of diclofenac diethyalamine salt in the treatment of lateral epicondylitis of the elbow. Curr Ther Res 1991;49:162-8
  • Mahler P, Mahler F, Duruz H, et al. Double-blind, randomized, controlled study on the efficacy and safety of a novel diclofenac epolamine gel formulated with lecithin for the treatment of sprains, strains and contusions. Drugs Exp Clin Res 2003;29:45-52
  • Solignac M. Assessment of a topical NSAIDs in the treatment of pain and inflammation. The example of Flector Plaster, a local bioadhesive plaster containing diclofenac epolamine. Presse Med 2004;33(Suppl 3):S10-3
  • White A. Osteoarthritis of the knee – an introduction. Acupunct Med 2006;24:S1-6
  • Seed MP, Brown JR, Freemantle CN. The inhibition of colon 26 adenocarcinoma development and angiogenesis by topical diclofenac in 2.5% hyaluronan. Cancer Res 1997;57:1625-9
  • Cortes R. Correspondence. Int J Dermatol 2002;44:371-3
  • Moore RA, Derry S, Phillips CJ, McQuay HJ. Nonsteroidal anti-inflammatory drugs (NSAIDs), cycloxygenase-2-selective inhibitors (coxibs) and gastrointestinal harm: review of clinical trials and clinical practice. BMC Musculoskelet Disord 2006;7:79-91
  • Le Fevre M. Topical diclofenac gel delivers in osteoarthritis. Inpharma Wkly 2007;1615:9-10
  • Kilminster SG, Mould GP. Comparison of diclofenac spray and gel on knee joints of patients with osteoarthritic pain. Clin Drug Invest 1999;18:345-54
  • Evans JMM, McMahon A, McGilchrist M, et al. Topical non-steroidal anti-inflammatory drugs and admission to hospital for upper gastrointestinal bleeding and perforation: a record linkage case-control study. BMJ 1995;311:22-6
  • Figueras A, Capella D, Castel JM. Spontaneous reporting of adverse drug reactions to non-steroidal anti-inflammatory drugs: a report from the Spanish System of Pharmacovigliance, including an early analysis of topical, enteric coated formulations. Eur J Clin Pharmacol 1994;47:297-303

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