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Topical Diclofenac Solution

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Abstract

  • ▴ Topical diclofenac solution (Pennsaid®) is a liquid formulation containing the NSAID diclofenac sodium (1.5% w/w). The solution base contains 45% w/w dimethyl sulfoxide (DMSO) to enhance the absorption of diclofenac through the skin. Topical diclofenac solution is applied directly to the knee for treatment of symptoms associated with osteoarthritis of the knee.

  • ▴ In well designed 4- to 12-week trials in patients with primary osteoarthritis of the knee, topical diclofenac solution (40 drops four times daily) was significantly more effective than placebo or vehicle control (carrier solution without diclofenac) for improving Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index pain and physical function, and improving patient global assessment (PGA) and/or patient overall health assessment scores from baseline to the final assessments.

  • ▴ Topical diclofenac solution (50 drops three times daily) was as effective as oral diclofenac 150 mg/day for improving WOMAC pain and physical function and PGA scores in a 12-week double-blind study in patients with osteoarthritis of the knee.

  • ▴ Topical diclofenac solution was generally well tolerated. The most common treatment-emergent adverse event experienced by topical diclofenac solution recipients was dry skin at the application site. Gastrointestinal adverse events and abnormal laboratory parameters were less common with topical diclofenac solution than with oral diclofenac.

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References

  1. Özgüney I. An alternative topical treatment of osteoarthritis of the knee with cutaneous diclofenac solution. Expert Opin Pharmacother 2008 Jul; 9(10): 1805–16

    Article  PubMed  Google Scholar 

  2. Zhang W, Moskowitz RW, Nuki G, et al. OARSI recommendations for the management of hip and knee osteoarthritis. Part II: OARSI evidence-based, expert consensus guidelines. Osteoarthritis Cartilage 2008 Feb; 16(2): 137–62

    CAS  Google Scholar 

  3. Brogden RN, Heel RC, Pakes GE, et al. Diclofenac sodium: a review of its pharmacological properties and therapeutic use in rheumatic diseases and pain of varying origin. Drugs 1980 Jul; 20(1): 24–48

    Article  PubMed  CAS  Google Scholar 

  4. 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 Apr; 24(4): 925–50

    Article  PubMed  CAS  Google Scholar 

  5. Hooper L, Brown TJ, Elliott RA, et al. The effectiveness of five strategies for the prevention of gastrointestinal toxicity induced by non-steroidal anti-inflammatory drugs: systematic review. BMJ 2004 Oct 23; 329(7472): 948

    Article  PubMed  CAS  Google Scholar 

  6. Pennsaid® (1.5% w/w diclofenac sodium solution): Canadian prescribing information. Montreal (QC): Paladin Labs Inc., 2009 Apr 14

  7. Pennsaid®: UK summary of product characteristics. London: Dimethaid (UK) Limited, 2004 Feb 26

  8. Pennsaid® topical solution (diclofenac sodium topical solution) 1.5% w/w: US prescribing information. Hazelwood (MO): Mallinckrodt Brand Pharmaceuticals, Inc., 2009 Nov

  9. Todd PA, Sorkin EM. Diclofenac sodium: a reappraisal of its pharmacodynamic and pharmacokinetic properties, and therapeutic efficacy. Drugs 1988 Mar; 35(3): 244–85

    Article  PubMed  CAS  Google Scholar 

  10. Hui X, Hewitt PG, Poblete N, et al. In vivo bioavailability and metabolism of topical diclofenac lotion in human volunteers. Pharm Res 1998 Oct; 15(10): 1589–95

    Article  PubMed  CAS  Google Scholar 

  11. Hewitt PG, Poblete N, Wester RC, et al. In vitro cutaneous disposition of a topical diclofenac lotion in human skin: effect of a multi-dose regimen. Pharm Res 1998 Jul; 15(7): 988–92

    Article  PubMed  CAS  Google Scholar 

  12. Tanojo H, Wester RC, Shainhouse JZ, et al. Diclofenac metabolic profile following in vitro percutaneous absorption through viable human skin. Eur J Drug Metab Pharmacokinet 1999 Oct-Dec; 24(4): 345–51

    Article  PubMed  CAS  Google Scholar 

  13. Baer PA, Thomas LM, Shainhouse Z. Treatment of osteoarthritis of the knee with a topical diclofenac solution: a randomised controlled, 6-week trial [ISRCTN53366886]. BMC Musculoskelet Disord 2005 Aug 8; 6 (44)

  14. Bookman AA, Williams KS, Shainhouse JZ. Effect of a topical diclofenac solution for relieving symptoms of primary osteoarthritis of the knee: a randomized controlled trial. CMAJ 2004 Aug 17; 171(4): 333–8

    Article  PubMed  Google Scholar 

  15. Roth SH, 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 Oct 11; 164(18): 2017–23

    Article  PubMed  CAS  Google Scholar 

  16. Simon LS, Grierson LM, Naseer Z, et al. Efficacy and safety of topical diclofenac containing dimethyl sulfoxide (DMSO) compared with those of topical placebo, DMSO vehicle and oral diclofenac for knee osteoarthritis. Pain 2009 Jun; 143(3): 238–45

    Article  PubMed  CAS  Google Scholar 

  17. 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 Oct; 31(10): 2002–12

    PubMed  CAS  Google Scholar 

  18. Pham T, Van Der Heijde D, Lassere M, et al. Outcome variables for osteoarthritis clinical trials: the OMERACT-OARSI set of responder criteria. J Rheumatol 2003 Jul; 30(7): 1648–54

    PubMed  Google Scholar 

  19. Towheed TE. Pennsaid therapy for osteoarthritis of the knee: a systematic review and metaanalysis of randomized controlled trials. J Rheumatol 2006 Mar; 33(3): 567–73

    PubMed  CAS  Google Scholar 

  20. Jones B, Jarvis P, Lewis JA, et al. Trials to assess equivalence: the importance of rigorous methods. BMJ 1996 Jul 6; 313(7048): 36–9

    Article  PubMed  CAS  Google Scholar 

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Acknowledgements and Disclosures

The manuscript was reviewed by: T.P. Anastassiades, Department of Medicine, Queen’s University, Kingston, Ontario, Canada; S.H. Roth, Arthritis Research Lab, Arizona State University and Arizona Research and Education, Arizona, USA.

The preparation of this review was not supported by any external funding. During the peer review process, the manufacturer of the agent under review was offered an opportunity to comment on this article. Changes resulting from comments received were made on the basis of scientific and editorial merit.

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  1. Adis, a Wolters Kluwer Business, 41 Centorian Drive, Private Bag 65901, Mairangi Bay, North Shore, Auckland, 0754, New Zealand

    Marit D. Moen

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Correspondence to Marit D. Moen.

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Moen, M.D. Topical Diclofenac Solution. Drugs 69, 2621–2632 (2009). https://doi.org/10.2165/11202850-000000000-00000

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