title: Topical diclofenac therapy for osteoarthritis: a meta-analysis of randomized controlled trials.
abstract: The objective of this study was to evaluate the efficacy and safety of topical diclofenac therapy for osteoarthritis (OA). A meta-analysis of randomized controlled trials was conducted. A comprehensive literature search, covering the databases of Medline, the Cochrane Central Register of Controlled Trials, and EMBASE, was conducted in September 2014 to identify the randomized controlled trials which adopted the topical diclofenac therapy for OA. A total of nine papers were included in this meta-analysis. Topical diclofenac appears to be effective in both pain relief (standard mean differences (SMD) = 0.40; 95 % confidence interval (CI) 0.19 to 0.62; P = 0.0003) and function improvement (SMD = 0.23; 95 % CI 0.03 to 0.43; P = 0.03) when compared with the control group. The sensitivity analysis and subgroup analysis showed that the result of pain intensity was stable and reliable, while the result of physical function improvement was vague. With respect to safety, topical diclofenac demonstrated a higher incidence of adverse events such as dry skin, rash, dermatitis, neck pain, and withdrawal. Topical diclofenac is effective in pain relief as a treatment of OA. It may also have a potential effect in function improvement, which needs further studies to be explored. Although, some adverse effects were observed in the application of topical diclofenac, none of them was serious.
authors.affiliation: Department of Orthopaedics, Xiangya Hospital, Central South University, #87 Xiangya Road, 410008, Changsha, Hunan Province, China.
authors.forename: Zhen-Han
authors.initials: ZH
authors.lastname: Deng
authors.affiliation: Department of Orthopaedics, Xiangya Hospital, Central South University, #87 Xiangya Road, 410008, Changsha, Hunan Province, China.
authors.forename: Chao
authors.initials: C
authors.lastname: Zeng
authors.affiliation: Department of Orthopaedics, Xiangya Hospital, Central South University, #87 Xiangya Road, 410008, Changsha, Hunan Province, China.
authors.forename: Ye
authors.initials: Y
authors.lastname: Yang
authors.affiliation: Department of Orthopaedics, Xiangya Hospital, Central South University, #87 Xiangya Road, 410008, Changsha, Hunan Province, China.
authors.forename: Yu-Sheng
authors.initials: YS
authors.lastname: Li
authors.affiliation: Department of Epidemiology and Health Statistics, School of Public Health, Central South University, 410008, Changsha, Hunan Province, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Wei
authors.affiliation: Department of Orthopaedics, Xiangya Hospital, Central South University, #87 Xiangya Road, 410008, Changsha, Hunan Province, China.
authors.forename: Tuo
authors.initials: T
authors.lastname: Yang
authors.affiliation: Department of Orthopaedics, Xiangya Hospital, Central South University, #87 Xiangya Road, 410008, Changsha, Hunan Province, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Li
authors.affiliation: Department of Orthopaedics, Xiangya Hospital, Central South University, #87 Xiangya Road, 410008, Changsha, Hunan Province, China. epidemiologymeta@sina.com.
authors.forename: Guang-Hua
authors.identifier: http://orcid.org/0000-0002-2468-3462
authors.initials: GH
authors.lastname: Lei
mesh_terms: D000287:Administration, Topical; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000627:therapeutic use*; D004008:Diclofenac / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D010003:Osteoarthritis / Q000188:drug therapy*; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D004008:Diclofenac
keywords: Adverse events; NSAID; Osteoarthritis; Pain; Physical function; Topical diclofenac