title: Copper-salicylate gel for pain relief in osteoarthritis: a randomised controlled trial.
abstract: OBJECTIVE
  To assess the efficacy and safety of a copper-salicylate gel in osteoarthritis of the hip and knee.
  
  
  METHODS
  Randomised, double-blind, placebo-controlled study.
  
  
  METHODS
  Rheumatology Clinic of St Vincent's Hospital, Sydney, New South Wales (a tertiary referral hospital), June 1993 to October 1994.
  
  
  METHODS
  116 patients with pain associated with osteoarthritis of the hip and/or knee (diagnosed by criteria of the European League against Rheumatism), drawn from patients attending the Clinic or self-referred after newspaper advertisements.
  
  
  METHODS
  Copper-salicylate or placebo gel (1.5 g) applied twice daily to the forearm for four weeks.
  
  
  METHODS
  Self-assessment of pain before the trial and after two and four weeks of treatment; patient and investigator assessments of efficacy; additional analgesia required; adverse reactions; and withdrawal rates.
  
  
  RESULTS
  Pain scores at rest and on movement decreased in both the copper-salicylate and placebo groups by 13%-20%. There was no significant difference between the two groups for decrease in pain score, patient and investigator efficacy ratings, number of patients requiring paracetamol for extra analgesia (active, 77%; placebo, 71%) and average dose of paracetamol (active, 555 mg/day; placebo, 600 mg/day). Significantly more patients in the copper-salicylate group reported adverse reactions (83% versus 52% of the placebo group), most commonly skin reactions, and withdrew from the trial because of these reactions (17% versus 1.7% of the placebo group).
  
  
  CONCLUSIONS
  Copper-salicylate gel applied to the forearm was no better than placebo gel as pain relief for patients with osteoarthritis of the hip or knee, but produced significantly more skin rashes.
authors.affiliation: Department of Clinical Pharmacology and Toxicology, St Vincent's Hospital, Sydney, NSW.
authors.forename: N A
authors.initials: NA
authors.lastname: Shackel
authors.forename: R O
authors.initials: RO
authors.lastname: Day
authors.forename: B
authors.initials: B
authors.lastname: Kellett
authors.forename: P M
authors.initials: PM
authors.lastname: Brooks
mesh_terms: D000279:Administration, Cutaneous; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage* / Q000009:adverse effects; D003300:Copper / Q000008:administration & dosage* / Q000009:adverse effects; D004311:Double-Blind Method; D005260:Female; D005782:Gels; D006801:Humans; D007719:Knee Joint; D008297:Male; D008875:Middle Aged; D009942:Organometallic Compounds / Q000008:administration & dosage* / Q000009:adverse effects; D010003:Osteoarthritis / Q000188:drug therapy*; D015207:Osteoarthritis, Hip / Q000188:drug therapy; D010147:Pain Measurement; D012459:Salicylates / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D005782:Gels; D009942:Organometallic Compounds; D012459:Salicylates; C025564:copper salicylate complex; D003300:Copper