Topical NSAIDs for acute pain in adults

摘要: Background Use of topical NSAIDs to treat acute musculoskeletal conditions is widely accepted in some parts the world, but not others. Their main attraction their potential provide pain relief without associated systemic adverse events. Objectives To review evidence from randomised, double-blind, controlled trials on efficacy and safety topically applied pain. Search methods We searched MEDLINE, EMBASE, The Cochrane Library, our own in-house database December 2009. We sought unpublished studies by asking personal contacts searching on-line clinical trial registers manufacturers web sites. Selection criteria We included active or placebo (inert carrier)-controlled which treatments were administered adult patients with resulting strains, sprains sports overuse-type injuries (twisted ankle, for instance). There had be at least 10 participants each treatment arm, application once daily. Data collection analysis Two authors independently assessed quality validity, extracted data. Numbers achieving outcome used calculate relative risk numbers needed (NNT) harm (NNH) compared other treatment. Main results Forty-seven included; most form a gel, spray, cream similar placebo, 3455 overall analysis efficacy. For all combined, number benefit success, equivalent 50% relief, was 4.5 (3.9 5.3) periods 6 14 days. Topical diclofenac, ibuprofen, ketoprofen, piroxicam efficacy, indomethacin benzydamine significantly better than placebo. Local skin reactions generally mild transient, did differ very few events withdrawals due events. insufficient data reliably compare individual same oral NSAID. Authors' conclusions Topical can good levels NSAIDs, when conditions.