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Topical NSAIDs for Acute Musculoskeletal Pain in Adults

 


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Am Fam Physician. 2016 Jul 1;94(1):online.

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TOPICAL NSAIDS FOR ACUTE MUSCULOSKELETAL PAIN IN ADULTS

Patients had improved pain control with topical NSAIDs compared with placebo without experiencing an increase in local or systemic adverse events.
NNT = 2 for diclofenac gel, 3 for ketoprofen gel, and 4 for ibuprofen
BenefitsHarms

1 in 2 had improved pain control with diclofenac gel

No increase in local adverse events such as erythema or pruritus

1 in 3 had improved pain control with ketoprofen gel

No increase in systemic adverse events such as headache, abdominal pain, or allergic reaction

1 in 4 had improved pain control with ibuprofen gel


NNT = number needed to treat; NSAIDs = nonsteroidal anti-inflammatory drugs.

TOPICAL NSAIDS FOR ACUTE MUSCULOSKELETAL PAIN IN ADULTS

Patients had improved pain control with topical NSAIDs compared with placebo without experiencing an increase in local or systemic adverse events.
NNT = 2 for diclofenac gel, 3 for ketoprofen gel, and 4 for ibuprofen
BenefitsHarms

1 in 2 had improved pain control with diclofenac gel

No increase in local adverse events such as erythema or pruritus

1 in 3 had improved pain control with ketoprofen gel

No increase in systemic adverse events such as headache, abdominal pain, or allergic reaction

1 in 4 had improved pain control with ibuprofen gel


NNT = number needed to treat; NSAIDs = nonsteroidal anti-inflammatory drugs.

Details for This Review

Study Population: Patients 16 years and older with acute pain from strains, sprains, or sports/overuse type injuries

Efficacy End Points: Clinical success was defined variably as at least 50% pain intensity reduction, good or excellent response, or marked improvement or complete remission.

Harm End Points: Local skin reactions, systemic adverse events

Narrative: Musculoskeletal conditions and injuries affect a significant number of persons worldwide.1 Nonsteroidal anti-inflammatory drugs (NSAIDs) can effectively treat painful conditions, but have been associated with adverse cardiovascular,

Author disclosure: No relevant financial affiliations.

REFERENCES

1. Global Burden of Disease Study 2013 Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2015;386(9995):743–800.

2. Nalamachu S. An overview of pain management: the clinical efficacy and value of treatment. Am J Manag Care. 2013;19(14 suppl):s261–s266.

3. Derry S, Moore RA, Gaskell H, McIntyre M, Wiffen PJ. Topical NSAIDs for acute musculoskeletal pain in adults. Cochrane Database Syst Rev. 2015;(6):CD007402.



 

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