Evaluation of topical therapy of patients with osteoarthritis of small joints of the hands with Voltaren® Emulgel® 2% (diclofenac diethylamine 2%)

Cover Page

Cite item

Full Text

Abstract

Aim. To evaluate the efficacy and safety of using the drug Voltaren® Emulgel® 2% (diclofenac diethylaminе 2%) for 14 days in patients with osteoarthritis (OA) of small joints of the hands.

Materials and methods. 62 patients of both sexes with hands OA were included in the study, 31 of whom (main group) used Voltaren® Emulgel® 2% (diclofenac diethylaminе 2%) topically, and the remaining 31 (comparison group) – Voltaren® Emulgel® 2% (diclofenac diethylamine 2%) + oral nonsteroidal anti-inflammatory drugs. The effectiveness of therapy was assessed by using a visual analogue scale (VAS) in dynamics: joint pain and stiffness at rest, pain on movement and during palpation, by functional indices AUSCAN, FIHOA, by assessment of the effect of therapy by the doctor and the patient on a weekly basis.

Results and discussion. Joint pain decreased after 2 weeks of therapy in all patients during treatment with Voltaren® Emulgel® 2% (diclofenac diethylamine 2%) in both groups. Significant reduction in stiffness and improvement in hand joint function was achieved after 7 days and lasted until the end of treatment. By the end of treatment, 100% of patients assessed their condition as improvement.

Conclusion. Voltaren® Emulgel® 2% (diclofenac diethylamine 2%) demonstrates comparable clinical efficacy in patients with OA of the hand joints (reduced pain, stiffness and improved joint function) in monotherapy as complex therapy in combination with oral NSAIDS, while being well tolerated.

About the authors

Vladimir V. Tsurko

Pirogov Russian National Research Medical University; Sechenov First Moscow State Medical University (Sechenov University)

Email: margarita-gromov@mail.ru
ORCID iD: 0000-0001-8040-3704

д-р мед. наук, проф. каф. факультетской терапии лечебного фак-та ФГАОУ ВО «РНИМУ им. Н.И. Пирогова», проф. каф. общей врачебной практики ФГАОУ ВО «Первый МГМУ им. И.М. Сеченова»

Russian Federation, Moscow; Moscow

Margarita A. Gromova

Pirogov Russian National Research Medical University

Author for correspondence.
Email: margarita-gromov@mail.ru
ORCID iD: 0000-0002-3757-058X

канд. мед. наук, ассистент каф. факультетской терапии лечебного фак-та

Russian Federation, Moscow

References

  1. Насонов Е.Л. Российские клинические рекомендации. Ревматология. М.: ГЭОТАР-Медиа, 2017 [Nasonov ЕL. Russian clinical guidelines. Rheumatology. Moscow: GEOTAR-Media, 2017 (in Russian)].
  2. Алексеева Л.И., Таскина Е.А., Кашеварова Н.Г. Остеоартрит: эпидемиология, классификация, факторы риска и прогрессирования, клиника, диагностика, лечение. Современная ревматология. 2019;13(2):9-21 [Alekseyeva LI, Taskina EA, Kashevarova NG. Osteoarthritis: epidemiology, classification, risk factors and progression, clinical presentation, diagnosis, treatment. Sovremennaya revmatologiya. 2019;13(2):9-21 (in Russian)]. doi: 10.14412/1996-7012-2019-2-9-21
  3. Bijlsma J, Berenbaum F, Lafeber P. Osteoarthritis: an update with relevance for clinical practice. Lancet. 2011;377(9783):2115-26. doi: 10.1016/S0140-6736(11)60243-2
  4. Kellgren JH, Lawrence JS. Radiological assessment of osteoarthrosis. Ann Rheum Dis. 1957;16(4):494-502. doi: 10.1136/ard.16.4.494
  5. Zhang W, Doherty M, Leeb BF, et al. EULAR evidence-based recommendations for the management of hand osteoarthritis: report of a Task Force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT). Ann Rheum Dis. 2007;66:377-88. doi: 10.1136/ard.2006.062091
  6. Hochberg MC, Altman RD, April KT, et al. American College of Rheumatology 2012 recommendations for the use of nonpharmacologic and pharmacologic therapies in osteoarthritis of the hand, hip, and knee. Arthritis Care Res (Hoboken). 2012;64:465-74. doi: 10.1002/acr.21596
  7. Kloppenburg M, Kroon FP, Blanco FJ, et al. 2018 update of the EULAR recommendations for the management of hand osteoarthritis. Ann Rheum Dis. 2019;78:16-24. doi: 10.1136/annrheumdis-2018-213826
  8. Kolasinski SL, Neogi T, Hochberg MC, et al. 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee. Arthritis Rheumatol. 2020;72:220-33. doi: 10.1002/art.41142
  9. Каратеев А.Е., Насонов Е.Л., Ивашкин В.Т., и др. Рациональное использование нестероидных противовоспалительных препаратов. Клинические рекомендации. Научно-практическая ревматология. 2018;56:1-29 [Karateev AE, Nasonov EL, Ivashkin VT, et al. Rational use of nonsteroidal anti-inflammatory drugs. Clinical guidelines. Nauchno-prakticheskaya revmatologiya. 2018;56:1-29 (in Russian)]. doi: 10.14412/1995-4484-2018-1-29
  10. Derry S, Wiffen PJ, Kalso EA, et al. Topical analgesics for acute and chronic pain in adults – an overview of Cochrane Reviews. Cochrane Database Syst Rev. 2017;5:CD008609. doi: 10.1002/14651858.CD008609.pub2
  11. Камчатнов П.Р., Евзельман М.А., Чугунов А.В. Лечение пожилых пациентов с дорсопатией. Медицинский совет. 2016:9:28-32 [Kamchatnov PR, Evzelman MA, Chugunov AV. Treatment of elderly patients with dorsopathy. Meditsinskiy sovet. 2016;9:28-32 (in Russian)]. doi: 10.21518/2079-701X-2016-9-28-32
  12. Predel HG, Hamelsky S, Gold M, Giannetti B. Efficacy and safety of diclofenac diethylamine 2.32% gel in acute ankle sprain. Med Sci Sports Exerc. 2012;44(9):1629-36. doi: 10.1249/MSS.0b013e318257ed41
  13. Müller M, Mascher H, Kikuta C, et al. Diclofenac concentrations in defined tissue layers after topical administration. Clin Pharmacol Ther. 1997;62(3):293-9. doi: 10.1016/S0009-9236(97)90032-1
  14. Altman R, Alarcon G, Appelrouth D, et al. The American College of Rheumatology criteria for the classification and reporting of osteoarthritis of the hand. Arthritis Rheum. 1990;33(11):1601-10. doi: 10.1002/art.1780331101
  15. Hawker GA, Mian S, Kendzerska T, French M. Measures of adult pain: Visual Analog Scale for Pain (VAS Pain), Numeric Rating Scale for Pain (NRS Pain), McGill Pain Questionnaire (MPQ), Short-Form McGill Pain Questionnaire (SF-MPQ), Chronic Pain Grade Scale (CPGS), Short Form-36 Bodily Pain Scale (SF-36 BPS), and Measure of Intermittent and Constant Osteoarthritis Pain (ICOAP). Arthritis Care Res (Hoboken). 2011;63(Suppl. 11):S240-52. doi: 10.1002/acr.20543
  16. Bellamy N, Campbell J, Haraoui B, et al. Clinimetric properties of the AUSCAN Osteoarthritis Hand Index: an evaluation of reliability, validity and responsiveness. Osteoarthritis Cartilage. 2002;10(11):863-9. doi: 10.1053/joca.2002.0838
  17. Dreiser RL, Maheu E, Guillou GB. Sensitivity to change of the functional index for hand osteoarthritis. Osteoarthritis Cartilage. 2000;8(Suppl. A): S25-8. doi: 10.1053/joca.2000.0332
  18. Parsaee S, Sarbolouki MN, Parnianpour M. In-vitro release of diclofenac diethylammonium from lipid-based formulations. Int J Pharm. 2002;241(1):185-90. doi: 10.1016/s0378-5173(02)00238-7
  19. Radermacher J, Jentsch D, Scholl MA, et al. Diclofenac concentrations in synovial fluid and plasma after cutaneous application in inflammatory and degenerative joint disease. Br J Clin Pharmacol. 1991;31(5):537-41. doi: 10.1111/j.1365-2125.1991.tb05576.x
  20. Baraf HS, Gold MS, Clark MB, Altman RD. Safety and efficacy of topical diclofenac sodium 1% gel in knee osteoarthritis: a randomized controlled trial. Phys Sportsmed. 2010;38(2):19-28. doi: 10.3810/psm.2010.06.1779
  21. Barthel HR, Haselwood D, Longley S, et al. Randomized controlled trial of diclofenac sodium gel in knee osteoarthritis. Semin Arthritis Rheum. 2009;39(3):203-12. doi: 10.1016/j.semarthrit.2009.09.002
  22. Gan TJ. Diclofenac: an update on its mechanism of action and safety profile. Curr Med Res Opin. 2010;26:1715-31.doi: 10.1185/03007995.2010.486301
  23. Da Costa BR, Reichenbach S, Keller N, et al. Effectiveness of non-steroidal anti-inflammatory drugs for the treatment of pain in knee and hip osteoarthritis: a network meta-analysis. Lancet. 2016;387(10033):2093-105. DOI:1016/s0140-6736(16)30002-2.

Copyright (c) 2021 Consilium Medicum

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
 
 


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies