PMID- 21231861
OWN - NLM
STAT- MEDLINE
DCOM- 20110614
LR  - 20191210
IS  - 1473-4877 (Electronic)
IS  - 0300-7995 (Linking)
VI  - 27
IP  - 3
DP  - 2011 Mar
TI  - Safety profile of topical diclofenac: a meta-analysis of blinded, randomized, 
      controlled trials in musculoskeletal conditions.
PG  - 605-22
LID - 10.1185/03007995.2010.550606 [doi]
AB  - BACKGROUND: Topical non-steroidal anti-inflammatory drugs (NSAIDs) are clinically 
      proven for the management of musculoskeletal conditions. It is important that 
      prescribers and patients are aware of the safety profile of topical NSAIDs. 
      OBJECTIVES: To evaluate the risk of adverse events (AEs) associated with topical 
      diclofenac for the treatment of acute and chronic musculoskeletal conditions. 
      DESIGN: Systematic review and meta-analysis of blinded, randomized, placebo-, 
      vehicle- or active-controlled trials. RESULTS: The risk of any type of AE 
      experienced with topical diclofenac was slightly higher compared with 
      placebo/vehicle (RR 1.11), but was more than 50% lower than the risk observed 
      with active topical comparators (RR 0.53). Absolute risk values indicated 
      differences in the risk of AEs depending on the diclofenac formulation used; in 
      particular, lower rates of local skin reactions were observed with diclofenac 
      patches (e.g. 2.5% in placebo/vehicle-controlled studies) and gels (4.2%) 
      compared with diclofenac solutions containing dimethylsulfoxide (34.2%). Dry 
      skin/crusting and rash were the most common local skin reactions reported (9.0% 
      and 3.0% of patients, respectively, in placebo/vehicle-controlled studies), which 
      were usually mild-to-moderate and self-resolving. The discontinuation rate due to 
      local skin reactions with topical diclofenac (1.9%) was low and comparable with 
      non-active comparators (0.7%), and the tolerability of topical diclofenac 
      treatment was rated as 'good' to 'excellent' by >90% physicians and patients. 
      CONCLUSIONS: Topical diclofenac appears to be generally well tolerated for 
      cutaneous use in acute and chronic musculoskeletal conditions.
FAU - Taylor, R S
AU  - Taylor RS
AD  - Peninsula College of Medicine & Dentistry, Universities of Exeter & Plymouth, 
      Exeter, UK. rod.taylor@pms.ac.uk
FAU - Fotopoulos, G
AU  - Fotopoulos G
FAU - Maibach, H
AU  - Maibach H
LA  - eng
PT  - Evaluation Study
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PT  - Systematic Review
DEP - 20110113
PL  - England
TA  - Curr Med Res Opin
JT  - Current medical research and opinion
JID - 0351014
RN  - 0 (Anti-Inflammatory Agents, Non-Steroidal)
RN  - 0 (Placebos)
RN  - 144O8QL0L1 (Diclofenac)
SB  - IM
MH  - Administration, Topical
MH  - Algorithms
MH  - Anti-Inflammatory Agents, Non-Steroidal/administration & dosage/adverse effects
MH  - Diclofenac/*administration & dosage/*adverse effects
MH  - Double-Blind Method
MH  - Drug-Related Side Effects and Adverse Reactions/*epidemiology
MH  - Humans
MH  - Musculoskeletal Diseases/*drug therapy/*epidemiology
MH  - Placebos
MH  - Randomized Controlled Trials as Topic/*statistics & numerical data
MH  - Single-Blind Method
EDAT- 2011/01/15 06:00
MHDA- 2011/06/15 06:00
CRDT- 2011/01/15 06:00
PHST- 2011/01/15 06:00 [entrez]
PHST- 2011/01/15 06:00 [pubmed]
PHST- 2011/06/15 06:00 [medline]
AID - 10.1185/03007995.2010.550606 [doi]
PST - ppublish
SO  - Curr Med Res Opin. 2011 Mar;27(3):605-22. doi: 10.1185/03007995.2010.550606. Epub 
      2011 Jan 13.