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Topical NSAIDs for acute pain: a meta-analysis
Lorna Mason1, R Andrew Moore, Jayne E Edwards
1Pain Research and Nuffield Department of Anaesthetics, University of Oxford, Oxford Radcliffe Hospital, The Churchill, Headington, Oxford, OX3 7LJ, UK. lorna.mason79@yahoo.com
BMC Family Practice
|May 19, 2004
Summary
Topical non-steroidal anti-inflammatory drugs (NSAIDs) effectively relieve acute pain from injuries like sprains. These topical NSAIDs are safe and well-tolerated, offering a good option for short-term pain management.
Area of Science:
- Pharmacology
- Pain Management
- Evidence-Based Medicine
Background:
- Previous reviews indicated topical NSAIDs' efficacy for acute pain, but drug differences and trial quality warranted an update.
- Reclassification of certain drugs and new trial data necessitated a comprehensive re-evaluation.
Purpose of the Study:
- To systematically review the efficacy and safety of topical non-steroidal anti-inflammatory drugs (NSAIDs) for acute pain conditions.
- To compare the effectiveness of individual topical NSAIDs and assess trial quality and bias.
Main Methods:
- Systematic review and meta-analysis of randomized double-blind trials comparing topical NSAIDs with placebo or active treatments.
- Data extraction focused on pain reduction at one week, adverse events, and withdrawals.
- Calculated relative benefit, number-needed-to-treat (NNT), and performed sensitivity analyses.
Main Results:
- Topical NSAIDs significantly outperformed placebo in 19 of 26 trials, with a pooled relative benefit of 1.6 (NNT 3.8).
- Ketoprofen showed superior efficacy compared to other topical NSAIDs; indomethacin showed minimal benefit over placebo.
- No significant differences in efficacy or safety were found when comparing topical NSAIDs to oral NSAIDs.
Conclusions:
- Topical NSAIDs are effective and safe for managing acute painful conditions over a one-week period.
- The findings support the use of topical NSAIDs as a viable treatment option for acute pain.