Characteristics of trials comparing efficacy and safety of topical NSAID vs oral NSAID vs placebo for OA.
| Trial | Trial Duration, wks | Study Arms | No. Topical Applications/day | Total | Topical Agent | No.of Subjects NSAID or Othera | Vehicle | Placebo |
|---|---|---|---|---|---|---|---|---|
| RCT: Topical NSAID vs Vehicle and/or Placebo | ||||||||
| Altman37 | 8 | 2 g/hand diclofenac 1% gel Vehicle gelb | 4 | 385 | 198 | –c | 187 | – |
| Baer24 | 6 | 1.3 ml diclofenac 1.5% solution Vehicle (contains DMSOd) | 4 | 216 | 107 | – | 109 | – |
| Bookman25 | 4 | 1.3 ml diclofenac 1.5% solution Vehicle (contains DMSO) Placebo solutione | 4 | 248 | 84 | – | 80 | 84 |
| Bruhlmann26 | 2 | 180 mg diclofenac epolamine Placebo patch | 2 | 103 | 51 | – | – | 52 |
| Dreiser29 | 15 days | 180 mg diclofenac epolamine Placebo patch | 2 | 155 | 78 | – | – | 77 |
| Grace30 | 2 | 2.5 g diclofenac 2% gel Vehicle gelf | 3 | 74 | 38 | – | 36 | – |
| Niethard31 | 3 | 4 g diclofenac 1.16% gel Placebo gel | 4 | 237 | 117 | – | – | 120 |
| Ottillinger32 | 4 | 3 g eltenac gel: 0.1% (9mg), 0.3% (27 mg), 1% (90 mg)g Placebo gele | 3 | 237 | 59, 60, 59 | – | – | 59 |
| Roth33 | 12 | 1.3 ml diclofenac 1.5% solution Vehicle (contains DMSO) | 4 | 326 | 164 | – | 162 | – |
| RCT: Topical NSAID vs Oral NSAIDh +/– Vehicle +/– Placebo | ||||||||
| Dickson8 | 4 | 1 g piroxicam 0.5% gel 400 mg ibuprofen PO tid | 3 | 235 | 117 | 118 | – | – |
| Rother9 | 6 | 110 mg ketoprofen gel 100 mg celecoxib PO bid Placebo (PO and gel) | 2 | 397 | 138 | 132 | – | 127 |
| Sandelin11 | 4 | 3 g eltenac 1% gel 50 mg diclofenac PO bid Placebo (PO bid and gel tid) | 3 | 281 | 124 | 78 | – | 79 |
| Simon13 | 12 | 1.2 ml diclofenac 1.5% solution 100 mg diclofenac SR PO daily Vehicle (contains DMSO) Placebo (PO and solutioni) | 4 | 623 | 154 | 151 | 161 | 157 |
| Tugwell10 | 12 | 1.55 ml diclofenac 1.5% solution 50 mg diclofenac PO tidj | 3 | 622 | 311 | 311 | – | – |
| RCT: Topical NSAID vs Topical Agent | ||||||||
| Waikakul34 | 4 | 1 g ketoprofen gel 1 g diclofenac emulgel | 4 | 85 | 43 | 42 | – | – |
| Widrig35 | 3 | Ibuprofen 5% gel Arnica gelk | 3 | 204 | 99 | 105 | – | – |
| Yip36 | > 2 | Methylsalicylate ointment | Variable | 4 | 4 | – | – | – |
| Case Reports | ||||||||
| Chow27 | 2 | Methylsalicylate ointment | “regularly” | 1 | 1 | – | – | – |
| Cooper28 | 2 | Traxam gell | – | 1 | 1 | – | – | – |
↵a Widrig35 used arnica gel in the second arm, not an NSAID.
↵b Vehicle gel composed of isopropyl alcohol, propylene glycol, cocoyl caprylocaprate, mineral oil, ammonia solution, perfume cream 45/3, carbomer 980, polyoxyl 20 cetostearyl ether, and purified water.
↵c Not mentioned in the text.
↵d DMSO is a carrier (absorption enhancer), without active NSAID, composed of dimethylsulphoxide (45.5%), propylene glycol, glycerin, ethanol, and water.
↵e Placebo topical agent used a token amount of DMSO, 4.55% wt/wt.
↵f Vehicle gel composed of pluronic lecithin organogel base.
↵g Ottillinger included 3 topical NSAID study arms; carrier composed of transparent polyacrylic acid gel with 2-propanol (no penetration enhancer).
↵h Subjects receiving topical and oral NSAID received appropriate placebo drug.
↵i Modified placebo solution composed of 2.3% DMSO.
↵j Placebo solution used with oral diclofenac was modified carrier using 2.3% DMSO.
↵k Arnica gel composed of 50 g tincture/100 g, DER 1:20 arnica.
↵l Traxam gel composed of biphenylacetic acid 3% pet, carbomer 10% aqueous, isopropanolamine 1% aqueous.