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Review: topical NSAIDs reduce pain in osteoarthritis only during the first 2 weeks of use

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Q Are topical non-steroidal anti-inflammatory drugs (NSAIDs) efficacious for treatment of osteoarthritis?


Embedded ImageData sources:

Medline, CINAHL, EMBASE/Excerpta Medica, Scientific Citation Index, and Cochrane Library (up to October 2003); reference lists; and conference abstracts from international societies of rheumatology (2002–3).

Embedded ImageStudy selection and assessment:

randomised controlled trials (RCTs) in any language that compared topical NSAIDs with placebo or oral NSAIDs in patients with clinical or radiographic evidence of osteoarthritis. Individual study quality was assessed based on randomisation, blinding, and withdrawals.

Embedded ImageOutcomes:

reduction in pain (global pain or pain at rest) from baseline, change in function or stiffness, and adverse events (eg, gastrointestinal, central nervous system, and local events).


13 trials (16 comparisons, n = 2224) met the selection criteria. Mean age of patients ranged from 61–67 years. Comparison groups were placebo (13 comparisons, …

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  • For correspondence: Dr W Zhang, University of Nottingham, City Hospital, Nottingham, UK.

  • Source of funding: UK Arthritis Research Campaign.