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Topical NSAIDs usually better option than oral

By Lilian Anekwe

Topical NSAIDs provide effective and safe pain relief for acute musculoskeletal pain in adults and should be recommended in preference to the oral forms of the drug, UK researchers suggest.

A gold-standard review by the Cochrane Collaboration included 47 studies, most of which compared topical NSAIDs in the form of a gel, spray, or cream with a similar placebo in 3,455 participants.

For all topical NSAIDs combined, compared with placebo, the number needed to treat to benefit for clinical success defined as equivalent to 50% pain relief – was 4.5 for treatment periods of six to 14 days.

Topical diclofenac, ibuprofen, ketoprofen, and piroxicam were of similar efficacy, but indomethacin and benzydamine were not significantly better than placebo.

Local skin reactions were generally mild and transient, and did not differ from placebo. There were very few systemic adverse events or withdrawals due to adverse events.

Dr Maura Moore, a pain researcher at the University of Oxford and the Cochrane Pain, Palliative and Supportive Care Group, concluded: ‘Topical NSAIDs can provide good levels of pain relief, without the systemic adverse events associated with oral NSAIDs, when used to treat acute musculoskeletal conditions.'

Cochrane Database of Systematic Reviews 2010, Issue 6. Art. No.: CD007402.

Topical NSAIDs better than oral drugs

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