Evidence map›Paper›PMID 33661967›Full record

Trial reportPloS one2021

Topical diclofenac vs placebo for the treatment of chronic Achilles tendinopathy: A randomized controlled clinical trial.

Erin Bussin, Brian Cairns, Tommy Gerschman, Michael Fredericson, Jim Bovard, Alex Scott

Open access · goldAbstract readRandomized Controlled Trial
In one paragraph

Trial report in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
1.6field-weighted citation impact, top 19% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 10 citations in OpenAlex.

  1. Guideline
  2. Review
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 2 countries.

Erin BussinFortius Sports Medicine, Burnaby, British Columbia, Canada.ORCID 0000-0003-3142-3068
Brian CairnsFaculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, Canada.
Tommy GerschmanDepartment of Pediatrics, University of British Colombia, Vancouver, Canada.
Michael FredericsonDepartment of Orthpaedic Surgery, Stanford University, Stanford, California, United States of America.
Jim BovardDepartment of Family Practice, University of British Columbia, Vancouver, Canada.
Alex ScottDepartment of Physical Therapy, University of British Columbia, Vancouver, Canada.ORCID 0000-0003-0366-8404
University of British Columbia · CAStanford University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe application of topical diclofenac has been suggested as a possible treatment for Achilles tendinopathy. Our aim was to answer the question, is topical diclofenac more effective than placebo for the treatment of Achilles tendinopathy?.

methods67 participants with persistent midportion or insertional Achilles tendinopathy were randomly assigned to receive a 4 week course of 10% topical diclofenac (n = 32) or placebo (n = 35). The a priori primary outcome measure was change in severity of Achilles tendinopathy (VISA-A score) at 4 and 12 weeks. Secondary outcome measures included numeric pain rating, and patient-reported change in symptoms using a 7 point scale, from substantially worse to substantially better. Pressure pain threshold (N) and transverse tendon stiffness (N/m) were measured over the site of maximum Achilles tendon pathology at baseline and 4 weeks.

resultsThere were no statistically or clinically significant differences between the diclofenac and placebo groups in any of the primary or secondary outcome measures at any timepoint. Average VISA-A score improved in both groups (p<0.0001), but the improvements were marginal: at 4 weeks, the improvements in VISA-A were 9 (SD 11) in the diclofenac group and 8 (SD 12) in the placebo group, and at 12 weeks the improvements were 9 (SD 16) and 11 (SD13) respectively-these average changes are smaller than the minimum clinically important difference of the VISA-A.

conclusionThe regular application of topical diclofenac for Achilles tendinopathy over a 4 week period was not associated with superior clinical outcomes to that achieved with placebo.

Indexed as

Administration, TopicalAdultAnalysis of VarianceAnti-Inflammatory Agents, Non-SteroidalChronic DiseaseDermatitis, ContactDiclofenacDouble-Blind MethodHumansMaleMiddle AgedOutcome Assessment, Health CarePainTendinopathyAnti-Inflammatory Agents, Non-SteroidalDiclofenac

Identifiers

PMID33661967
PMCPMC7932128
OpenAlexW3133513480

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.