From the Guidelines
NSAID patches, specifically diclofenac, are recommended for managing knee osteoarthritis pain due to their effectiveness and favorable safety profile compared to oral NSAIDs. The use of NSAID patches has been supported by a systematic review by Derry et al, which found topical diclofenac to be superior to placebo and equivalent to oral diclofenac in reducing pain associated with osteoarthritis of the knee 1. Key benefits of NSAID patches include:
- Reduced gastrointestinal adverse events compared to oral NSAIDs
- Targeted pain relief with minimal systemic absorption
- Effective for localized pain conditions like arthritis, muscle strains, or sprains
- Can be a suitable alternative for patients who cannot tolerate oral NSAIDs or prefer localized treatment. When using NSAID patches, it is essential to follow the recommended application guidelines, including applying the patch to clean, dry skin, free of cuts or irritation, and securing it firmly over the painful area. While NSAID patches may cause skin irritation in some users, the overall safety profile, as reported in a study published in the Mayo Clinic Proceedings, supports their use for up to 1 year with a consistent safety profile 1.
From the Research
NASIDs Patch Overview
- The NASIDs patch is a topical nonsteroidal anti-inflammatory drug (NSAID) used for the treatment of acute, localized, soft tissue injuries or painful conditions 2.
- Topical NSAIDs have been used for many years in Europe, with extensive post-marketing data available for some of the agents 2.
- Three topical NSAID formulations have recently been approved for use in the United States: the diclofenac epolamine topical patch 1.3% (DETP), diclofenac sodium 1% gel, and diclofenac sodium topical solution 1.5% 2.
Efficacy of NASIDs Patch
- Review of published, randomized clinical trials and meta-analyses shows that topical NSAIDs are significantly more effective than placebo in relieving acute pain; the pooled average relative benefit was 1.7 (95% confidence interval, 1.5-1.9) 3.
- In patients with acute soft tissue injuries treated with DETP, clinical data report an analgesic benefit within hours of the first application, and significant pain relief relative to placebo within 3 days 3.
- Topical diclofenac is widely used in the treatment of pain and inflammation, and studies demonstrate that the drug preferentially distributes to the target tissues in sufficient concentrations to produce a therapeutic effect 4.
Safety of NASIDs Patch
- Topical NSAIDs have minimal systemic absorption and risk of related adverse events, making them a safer option compared to traditional NSAIDs and cyclooxygenase-2 (COX-2) inhibitors (coxibs) 2.
- The most common adverse events associated with DETP are pruritus and other application site reactions 3.
- Topical diclofenac is well tolerated, resulting mostly in mild, easily resolved local skin irritation, and is associated with fewer side-effects than other topical NSAIDs and a lower rate of gastrointestinal complications than oral NSAIDs 4.