What is the recommended use of ketoprofen (nonsteroidal anti-inflammatory drug) plaster for pain management?

Ketoprofen Plaster for Pain Management

Topical ketoprofen plaster is an effective treatment option for localized musculoskeletal pain, providing good pain relief with minimal systemic absorption and fewer adverse effects compared to oral NSAIDs. 1, 2

Mechanism and Formulation

• Ketoprofen is a non-steroidal anti-inflammatory drug (NSAID) with analgesic, antipyretic, and anti-inflammatory properties 2
• The topical patch delivery system dispenses therapeutic doses directly to the site of injury, maintaining high tissue concentrations while keeping plasma levels low (less than 10% of oral bioavailability) 1
• The plaster formulation facilitates continuous drug delivery over a 24-hour period, allowing the medication to remain present in the tissues beneath the application site 1

Indications for Use

• Recommended for localized musculoskeletal pain conditions including:
  • Non-articular rheumatism 1
  • Traumatic painful soft tissue injuries 1
  • Acute musculoskeletal conditions such as sprains, strains, and sports injuries 3
  • Osteoarthritis pain 4
  • Inflammatory arthritis pain 4

Efficacy

• Clinical trials demonstrate that ketoprofen plaster is significantly more effective than placebo at reducing pain during daily activities and spontaneous pain after 7 days of treatment 1
• Topical NSAIDs, including ketoprofen formulations, provide good levels of pain relief in acute musculoskeletal conditions, with efficacy comparable to oral NSAIDs 3
• Ketoprofen gel has shown particularly good efficacy with an NNT (number needed to treat) of 2.5 for at least 50% pain relief 3
• Topical NSAIDs are effective for treating inflammatory pain, particularly bone pain 4

Advantages Over Oral NSAIDs

• Minimizes systemic absorption, resulting in significantly lower plasma concentrations compared to oral administration 1, 2
• Reduces risk of gastrointestinal adverse events commonly associated with oral NSAIDs 1, 2
• Provides targeted pain relief directly at the site of application 1
• Particularly beneficial for patients at high risk for NSAID-related adverse effects, including elderly patients and those with renal, GI, or cardiac risk factors 4

Application Instructions

• Apply the plaster directly to the affected area with intact skin 1
• Each plaster can be worn for up to 24 hours, providing continuous drug delivery 1
• The treated skin area should not be exposed to direct sunlight or solarium (sunbeds) during treatment and for 2 weeks afterward due to risk of photosensitization 2

Safety Considerations

• Adverse events are primarily cutaneous in nature (local skin reactions) and generally mild and transient 1, 3
• The incidence of gastrointestinal adverse events is low (<8%) and comparable to placebo 1
• Contraindicated in patients with known hypersensitivity to ketoprofen or other NSAIDs 5
• Use with caution in patients with compromised renal function, as with all NSAIDs 4
• Should not be used on broken or damaged skin 2

Special Populations

• Particularly beneficial for elderly patients (>75 years) who are at higher risk for NSAID-related adverse effects 5
• Appropriate for patients with hypoalbuminemia and reduced renal function who would be at greater risk from oral NSAID therapy 5
• Can be considered for patients with a history of peptic ulcer disease or significant alcohol use who require NSAID therapy 4

Alternative Topical NSAID Options

• If ketoprofen plaster is unavailable or not tolerated, other topical NSAID formulations with proven efficacy include:
  • Diclofenac gel (particularly Emulgel formulation) 3
  • Ibuprofen gel 3
  • Topical lidocaine 5% for neuropathic pain components 4

Monitoring and Follow-up

• Assess response to therapy after 7 days of treatment 1
• Monitor for local skin reactions at the application site 1, 2
• Discontinue use if photosensitivity reactions or significant skin irritation occurs 2