Celecoxib plus topical flurbiprofen patch versus celecoxib alone for symptomatic knee OA: a randomized controlled...

Rapid symptom control may facilitate earlier mobility and self-management in symptomatic knee OA (KOA), but evidence for combining oral and topical NSAIDs remains limited. This study aimed to determine whether adding a topical flurbiprofen patch to oral celecoxib provides greater short-term improvements in pain, physical function, quality of life and patient global assessment (PGA) than oral celecoxib alone in patients with symptomatic KOA.

In this open-label randomized controlled trial conducted at a tertiary academic hospital from January 2024 to March 2025, 90 patients with chronic inflammatory symptomatic KOA were randomized 1:1 to receive either oral celecoxib 200 mg once daily or celecoxib plus topical flurbiprofen patch twice daily. Outcomes were assessed at baseline and on days 3, 7 and 14. Primary outcomes were pain severity by visual analogue scale (VAS) and functional impairment by WOMAC. Secondary outcomes included quality of life by SF-36 and PGA.

Eighty-nine patients completed the study (45 celecoxib; 44 combination therapy). Baseline characteristics were comparable between the groups. Compared with celecoxib alone, combination therapy produced greater early pain relief, with larger VAS reductions on day 3 (3.4 ± 0.9 vs 2.0 ± 0.8, P < 0.01) and day 7 (3.9 ± 1.0 vs 3.3 ± 1.0, P = 0.02), but not day 14. WOMAC improvement was greater in the combination group on days 3, 7 and 14 (all P < 0.01). At day 14, SF-36 health domain scores and PGA ratings were also higher with combination therapy.

Adding topical flurbiprofen patch to oral celecoxib provided faster early improvement in pain and function and better short-term patient-reported outcomes in symptomatic KOA.

Chinese Clinical Trial Registry: ChiCTR1800014584.