A Prospective Study on Comparison of Transdermal Diclofenac Patch with Oral Diclofenac as An Analgesic Modality in the Treatment of Knee Osteoarthritis

Indian Journal of Pharmaceutical Education and Research

  • M. Christina Balapriya1Department of Pharmacy Practice, Krupanidhi College of Pharmacy, Bengaluru, Karnataka, INDIA.
  • Raman Dang1Department of Pharmacy Practice, Krupanidhi College of Pharmacy, Bengaluru, Karnataka, INDIA.
  • Beulah Milton1Department of Pharmacy Practice, Krupanidhi College of Pharmacy, Bengaluru, Karnataka, INDIA.
  • Ravikumar2Department of Orthopedics, MVJ Medical College and Research Hospital, Bengaluru, Karnataka, INDIA.
  • Mahesh Basanagauda Mudhol3Department of Pharmacology, MVJ Medical College and Research Hospital, Bengaluru, Karnataka, INDIA.

Volume 60 Issue krupapharmacon Pages 76-83

DOI: 10.5530/ijper.krupapharmacon.25

Abstract

Background: Knee osteoarthritis is a relatively common degenerative joint disorder in the world and one of the leading reasons behind chronic pain, disability, and impaired quality of life among the elderly population. Diclofenac Non-steroidal anti-inflammatory drugs, especially diclofenac, are still a strength of pharmacological treatment because of their pain-killing effects as well as anti-inflammatory effects. Materials and Methods: Nevertheless, there are severe systemic side effects of oral NSAID treatment, such as gastrointestinal bleeding, cardiovascular, and renal dysfunction. The current study was meant to determine the effectiveness and safety of transdermal diclofenac patch versus oral diclofenac in patients with knee osteoarthritis. Results: The study was a prospective randomized controlled study that involved 100 patients with knee osteoarthritis. The main results were the decrease of the level of pain measured with the help of the Visual Analogue Scale, the functional status measured with the help of the PROMIS Physical Function scores, and the quality of life measured with the help of the SF-36 questionnaire. Adverse drug reactions, patient satisfaction and rescue medication were the secondary outcomes. Transdermal diclofenac patients did not show any difference in pain relievers or functional results as compared to oral diclofenac group. Nevertheless, the incidence of systemic adverse effects was lower in transdermal group especially gastrointestinal complaints. The transdermal treatment group also showed improved patient compliance and patient satisfaction. Conclusion: Transdermal diclofenac patches are just as effective in pain relieving as oral diclofenac with a more favorable safety profile. These results propose transdermal delivery system to be a safer and more sustainable treatment mode of long-term management of knee osteoarthritis, particularly in the aged.

Keywords

  • Diclofenac
  • Drug safety
  • Knee osteoarthritis
  • NSAIDs
  • Randomized controlled study
  • Transdermal patch
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