title: Effectiveness of diclofenac versus paracetamol in knee osteoarthritis: a randomised controlled trial in primary care.
abstract: BACKGROUND
  The effectiveness of diclofenac versus paracetamol in primary care patients with pain caused by knee osteoarthritis is unclear.
  
  
  OBJECTIVE
  To assess the effectiveness of diclofenac compared with paracetamol over a period of 2, 4, and 12 weeks in patients with knee osteoarthritis.
  
  
  METHODS
  Randomised controlled trial in general practice.
  
  
  METHODS
  There were 104 patients included in the study, they were aged ≥45 years consulting their GP with knee pain caused by knee osteoarthritis. Patients were randomly allocated to diclofenac (n = 52) or paracetamol (n = 52) for at least 2 weeks. Primary outcomes were daily knee pain severity, and knee pain and function measured with the Knee Injury and Osteoarthritis Outcome Score (KOOS).
  
  
  RESULTS
  Over a period of 2- and 4-weeks follow-up, no significant difference in daily knee pain was found between the patient groups: estimated differences of 0.5 (95% CI = -0.2 to 1.3) and -0.2 (95% CI = -1.0 to 0.7), respectively. Over the 12-weeks follow-up, no significant differences were found between both groups for KOOS pain: estimated difference of -2.8 (95% CI = -10.7 to 5.1) and KOOS function of -2.7 (-10.6 to 5.0).
  
  
  CONCLUSIONS
  Over a period of 2- and 4-weeks follow-up no significant difference in daily measured knee pain severity was found between primary care patients with knee osteoarthritis taking paracetamol or diclofenac. Also, over a period of 12-weeks follow-up no significant differences were found regarding KOOS pain and KOOS function between both groups. Patients more frequently reported minor adverse events after taking diclofenac (64%) than paracetamol (46%).
authors.affiliation: Department of General Practice;
authors.forename: Saskia P J
authors.initials: SP
authors.lastname: Verkleij
authors.affiliation: Department of General Practice;
authors.forename: Pim A J
authors.initials: PA
authors.lastname: Luijsterburg
authors.affiliation: Department of Biostatistics, Erasmus MC University Medical Center Rotterdam, the Netherlands.
authors.forename: Sten P
authors.initials: SP
authors.lastname: Willemsen
authors.affiliation: Department of General Practice;
authors.forename: Bart W
authors.initials: BW
authors.lastname: Koes
authors.affiliation: Department of General Practice;
authors.forename: Arthur M
authors.initials: AM
authors.lastname: Bohnen
authors.affiliation: Department of General Practice and Department of Orthopaedic Surgery, Erasmus MC University Medical Center, Rotterdam, the Netherlands.
authors.forename: Sita M A
authors.initials: SM
authors.lastname: Bierma-Zeinstra
mesh_terms: D000082:Acetaminophen / Q000627:therapeutic use*; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D002985:Clinical Protocols; D004008:Diclofenac / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D020370:Osteoarthritis, Knee / Q000188:drug therapy* / Q000503:physiopathology; D010147:Pain Measurement; D017060:Patient Satisfaction; D011320:Primary Health Care; D016896:Treatment Outcome; D016474:Weight-Bearing
chemical_list: D018712:Analgesics, Non-Narcotic; D000894:Anti-Inflammatory Agents, Non-Steroidal; D004008:Diclofenac; D000082:Acetaminophen
keywords: diclofenac; general practice; knee osteoarthritis; paracetamol; randomised controlled trial