SynthesisBMC family practice2004
Topical NSAIDs for acute pain: a meta-analysis.
Synthesis in BMC family practice, 2004. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00471393 (Double-blind Randomized Clinical Study on Topical Diclofenac Efficacy in Symptomatic Relief of Temporomandibular Degenerative Joint Disease in Women.), which is not on this map. Cited by 35 papers, 9 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Double-blind Randomized Clinical Study on Topical Diclofenac Efficacy in Symptomatic Relief of Temporomandibular Degenerative Joint Disease in Women.
Who cites it
35 citing papers in PubMed, 9 syntheses or guidelines pooled it.
- Topical NSAIDs for chronic musculoskeletal pain in adults.The Cochrane database of systematic reviews · 2016Pooled it
- Topical NSAIDs for acute musculoskeletal pain in adults.The Cochrane database of systematic reviews · 2015Pooled it
- Topical NSAIDs for chronic musculoskeletal pain in adults.The Cochrane database of systematic reviews · 2012Pooled it
- Pooled it
- NSAIDs.BMJ clinical evidence · 2010Pooled it
- Topical NSAIDs for acute pain in adults.The Cochrane database of systematic reviews · 2010Pooled it
- Adverse effects of topical nonsteroidal antiinflammatory drugs in older adults with osteoarthritis: a systematic literature review.The Journal of rheumatology · 2010Pooled it
- NSAIDs.BMJ clinical evidence · 2007Pooled it
- Topical NSAIDs for chronic musculoskeletal pain: systematic review and meta-analysis.BMC musculoskeletal disorders · 2004Pooled it
- Analgesic effects of indomethacin spray on drug-induced oral mucositis pain in patients with cancer: A single-arm cross-sectional study.Special care in dentistry : official publication of the American Association of Hospital Dentists, the Academy of Dentistry for the Handicapped, and the American Society for Geriatric Dentistry · 2021Trial
- A clinical and mechanistic study of topical borneol-induced analgesia.EMBO molecular medicine · 2017Trial
- Penetration of topical diclofenac sodium 4 % spray gel into the synovial tissue and synovial fluid of the knee: a randomised clinical trial.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2014Trial
- Efficacy and safety of diclofenac diethylamine 1.16% gel in acute neck pain: a randomized, double-blind, placebo-controlled study.BMC musculoskeletal disorders · 2013Trial
- Diclofenac epolamine plus heparin plaster versus diclofenac epolamine plaster in mild to moderate ankle sprain: a randomized, double-blind, parallel-group, placebo-controlled, multicentre, phase III trial.Clinical drug investigation · 2011Trial
- Treatment of osteoarthritis of the knee with a topical diclofenac solution: a randomised controlled, 6-week trial [ISRCTN53366886].BMC musculoskeletal disorders · 2005Trial
- Article
- A database to initiate methodological advances in the evaluation of transitivity assumption in network meta-analysis: qualitative features and limitations of the tracenma R package.BMC medical research methodology · 2025Article
- Treatment of Acute Sore Throat in Malaysia: A Consensus of Multidisciplinary Recommendations Using Modified Delphi Methodology.Infection and drug resistance · 2024Review
- Comparative evaluation of efficacy of diclofenac and ketoprofen administered using transdermal drug delivery route in management of post endodontic pain: A randomized controlled clinical trial.Journal of conservative dentistry and endodontics · 2024Article
- Comparative Evaluation of the Efficacy of Two Modes of Delivery of Diclofenac for the Management of Post-Endodontic Pain: A Randomized Controlled Clinical Trial.Journal of pharmacy & bioallied sciences · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundA previous systematic review reported that topical NSAIDs were effective in relieving pain in acute conditions like sprains and strains, with differences between individual drugs for efficacy. More trials, a better understanding of trial quality and bias, and a reclassification of certain drugs necessitate a new review.
methodsStudies were identified by searching electronic databases and writing to manufacturers. We selected randomised double blind trials comparing topical NSAID with either placebo or another active treatment in adults with acute pain, and extracted dichotomous information approximating to a 50% reduction in pain at one week, together with details of adverse events and withdrawals. Relative benefit and number-needed-to-treat (NNT), and relative risk and number-needed-to-harm (NNH) were calculated, with sensitivity analyses where appropriate to investigate differences between individual drugs and aspects of trial design.
resultsTwenty-six double blind placebo controlled trials had information from 2,853 patients for evaluation of efficacy. Topical NSAID was significantly better than placebo in 19 of the 26 trials, with a pooled relative benefit of 1.6 (95% confidence interval 1.4 to 1.7), and NNT of 3.8 (95% confidence interval 3.4 to 4.4) compared with placebo for the outcome of half pain relief at seven days. Results were not affected by outcome reported, or condition treated, but smaller trials yielded a larger estimate of efficacy. Indirect comparisons of individual topical NSAIDs showed that ketoprofen was significantly better than all other topical NSAIDs, while indomethacin was barely distinguished from placebo. Three trials, with 433 patients, compared topical with oral NSAID (two trials compared the same drug, one compared different drugs) and found no difference in efficacy. Local adverse events, systemic adverse events, or withdrawals due to an adverse event were rare, and no different between topical NSAID and placebo.
conclusionsTopical NSAIDs were effective and safe in treating acute painful conditions for one week.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.