SynthesisThe Journal of rheumatology2010
Adverse effects of topical nonsteroidal antiinflammatory drugs in older adults with osteoarthritis: a systematic literature review.
Synthesis in The Journal of rheumatology, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 47 papers, 5 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
47 citing papers in PubMed, 5 syntheses or guidelines pooled it, 104 citations in OpenAlex.
- Clinical Practice Guidelines for Topical NSAIDs in the Treatment of Sports Injuries.Journal of evidence-based medicine · 2025Guideline
- Non-steroidal anti-inflammatory drugs (NSAIDs) for trigger finger.The Cochrane database of systematic reviews · 2021Pooled it
- Safety of Topical Non-steroidal Anti-Inflammatory Drugs in Osteoarthritis: Outcomes of a Systematic Review and Meta-Analysis.Drugs & aging · 2019Pooled it
- Relative efficacy and safety of topical non-steroidal anti-inflammatory drugs for osteoarthritis: a systematic review and network meta-analysis of randomised controlled trials and observational studies.British journal of sports medicine · 2018Pooled it
- Topical NSAIDs for acute musculoskeletal pain in adults.The Cochrane database of systematic reviews · 2015Pooled it
- Safety and Efficacy of the FLECTOR (Diclofenac Epolamine) Topical System in Children with Minor Soft Tissue Injuries: A Phase IV Non-randomized Clinical Trial.Clinical drug investigation · 2022Trial
- A double-blinded randomized clinical trial: Topical Sahasthara extractJournal of traditional and complementary medicine · 2026Article
- Absence of pharmacovigilance signals for bleeding events associated with warfarin-SSRI drug interactions: a comparative analysis of FAERS and CVARD databases.Therapeutic advances in drug safety · 2026Article
- Knee Osteoarthritis: Current Insights Into Pathophysiology and Non-surgical Management Options.Cureus · 2025Review
- Knee osteoarthritis: disease burden, available treatments, and emerging options.Therapeutic advances in musculoskeletal disease · 2024Review
- Isothiocyanate-rich moringa seed extract reduces skin inflammation in mouse ear edema model.Phytomedicine plus : international journal of phytotherapy and phytopharmacology · 2023Article
- Review
- An approach to treating older adults with chronic kidney disease.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2023Review
- Non-steroidal anti-inflammatory drugs in chronic kidney disease and risk of acute adverse kidney events according to route of administration.International urology and nephrology · 2023Article
- Multidisciplinary Guidelines for the Rational Use of Topical Non-Steroidal Anti-Inflammatory Drugs for Musculoskeletal Pain (2022).Journal of clinical medicine · 2023Review
- Efficacy and safety of acupuncture for hand osteoarthritis: study protocol for a multi-center, randomized, sham-controlled clinical trial.Journal of orthopaedic surgery and research · 2023Article
- Content, Structure and Delivery Characteristics of Yoga Interventions for the Management of Osteoarthritis: A Systematic Review Protocol.International journal of environmental research and public health · 2022Article
- Safety of Non-Steroidal Anti-Inflammatory Drugs in the Elderly: An Analysis of Published Literature and Reports Sent to the Portuguese Pharmacovigilance System.International journal of environmental research and public health · 2022Review
- Pharmacological management of chronic non-cancer pain in frail older people.Australian prescriber · 2022Review
- Can cryptogenic multifocal ulcerous stenosing enteritis (CMUSE) be diagnosed in a patient with non-steroidal anti-inflammatory drug exposure?BMJ case reports · 2021Article
Corrections and comments
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
Abstract
objectiveTo systematically review the literature on reported adverse effects (AE) associated with use of topical nonsteroidal antiinflammatory drugs (NSAID) in older adults with osteoarthritis (OA).
methodsA systematic search of Medline (1950 to November 2009), Scopus, Embase, Web of Science, Cochrane databases, Dissertation and American College of Rheumatology meeting abstracts was performed to identify original randomized controlled trials, case reports, observational studies, editorials, or dissertations reporting AE from topical NSAID in older adults with OA. Information was sought on study and participant characteristics, detailed recording of application site, and systemic AE as well as withdrawals due to AE.
resultsThe initial search yielded 953 articles of which 19 met eligibility criteria. Subjects receiving topical NSAID reported up to 39.3% application site AE, and up to 17.5% systemic AE. Five cases of warfarin potentiation with topical agents were reported, 1 resulting in gastrointestinal bleeding. In formal trials, the withdrawal rate from AE ranged from 0 to 21% in the topical agents, 0 to 25% in the oral NSAID, and 0 to 16% in the placebo group.
conclusionAlthough topical NSAID are safer than oral NSAID (fewer severe gastrointestinal AE), a substantial proportion of older adults report systemic AE with topical agents. The withdrawal rate due to AE with topical agents is comparable to that of oral NSAID. Given the safety profile and withdrawal rates described in this study, further data are needed to determine the incremental benefits of topical NSAID compared to other treatment modalities in older adults with OA.
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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.