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Topical diclofenac therapy for osteoarthritis: a meta-analysis of randomized controlled trials

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Abstract

The objective of this study was to evaluate the efficacy and safety of topical diclofenac therapy for osteoarthritis (OA). A meta-analysis of randomized controlled trials was conducted. A comprehensive literature search, covering the databases of Medline, the Cochrane Central Register of Controlled Trials, and EMBASE, was conducted in September 2014 to identify the randomized controlled trials which adopted the topical diclofenac therapy for OA. A total of nine papers were included in this meta-analysis. Topical diclofenac appears to be effective in both pain relief (standard mean differences (SMD) = 0.40; 95 % confidence interval (CI) 0.19 to 0.62; P = 0.0003) and function improvement (SMD = 0.23; 95 % CI 0.03 to 0.43; P = 0.03) when compared with the control group. The sensitivity analysis and subgroup analysis showed that the result of pain intensity was stable and reliable, while the result of physical function improvement was vague. With respect to safety, topical diclofenac demonstrated a higher incidence of adverse events such as dry skin, rash, dermatitis, neck pain, and withdrawal. Topical diclofenac is effective in pain relief as a treatment of OA. It may also have a potential effect in function improvement, which needs further studies to be explored. Although, some adverse effects were observed in the application of topical diclofenac, none of them was serious.

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Contributors

Guang-hua Lei, Zhen-han Deng, and Chao Zeng selected the studies. Guang-hua Lei wrote the manuscript. Zhen-han Deng and Chao Zeng helped in writing the manuscript. Ye Yang, Yu-sheng Li, Jie Wei, Tuo Yang, and Hui Li reviewed the manuscript. All authors contributed to the design of the study.

Funding

This work was supported by the Fundamental Research Funds for the Central Universities of Central South University (2014zzts347), the Hunan Provincial Innovation Foundation for Postgraduate (CX2014A005), the National Natural Science Foundation of China (Nos. 81201420, 81272034, 81472130), the Provincial Science Foundation of Hunan (No. 14JJ3032), the Scientific Research Project of the Development and Reform Commission of Hunan Province ([2013]1199), the Scientific Research Project of Science and Technology Office of Hunan Province (2013SK2018), and the Doctoral Scientific Fund Project of the Ministry of Education of China (20120162110036).

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    Authors and Affiliations

    1. Department of Orthopaedics, Xiangya Hospital, Central South University, #87 Xiangya Road, 410008, Changsha, Hunan Province, China

      Zhen-han Deng, Chao Zeng, Ye Yang, Yu-sheng Li, Tuo Yang, Hui Li & Guang-hua Lei

    2. Department of Epidemiology and Health Statistics, School of Public Health, Central South University, 410008, Changsha, Hunan Province, China

      Jie Wei

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    1. Zhen-han Deng
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    Zhen-han Deng and Chao Zeng contributed equally to this work.

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    Deng, Zh., Zeng, C., Yang, Y. et al. Topical diclofenac therapy for osteoarthritis: a meta-analysis of randomized controlled trials. Clin Rheumatol 35, 1253–1261 (2016). https://doi.org/10.1007/s10067-015-3021-z

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