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Diclofenac sodium topical solution with dimethyl sulfoxide, a viable alternative to oral nonsteroidal anti-inflammatories in osteoarthritis: review of current evidence

Authors Fuller P, Roth S

Published 11 July 2011 Volume 2011:4 Pages 223—231


Review by Single-blind

Peer reviewer comments 2

Philip Fuller¹, Sanford Roth²
¹Covidien, Hazelwood, MO; ²Arizona Research and Education, Arthritis Research Laboratory, Arizona State University, Phoenix, AZ, USA

Abstract: Topical nonsteroidal anti-inflammatory drugs (NSAIDs) may offer a safer alternative to their oral counterparts for the management of osteoarthritis. Diclofenac sodium topical solution with dimethyl sulfoxide (TDiclo) was evaluated in five randomized, controlled trials and is indicated for treatment of the signs and symptoms associated with osteoarthritis of the knee. Three studies showed that TDiclo is superior to placebo and vehicle control with respect to pain, physical function, and perception of osteoarthritis symptoms. Two studies showed that benefits are similar to those of oral diclofenac, with one study demonstrating statistical equivalence. The most common adverse event associated with TDiclo in these studies was dry skin. Incidences of gastrointestinal adverse events and abnormal levels of liver enzymes were lower with TDiclo compared with oral diclofenac in active-controlled studies. Based on these studies, TDiclo represents a practical, evidence-based option for the management of osteoarthritis of the knee.

Keywords: osteoarthritis, nonsteroidal anti-inflammatory drugs, diclofenac, topical analgesic

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