New recommendations for local therapy of knee osteoarthritis and study of ketoprofen efficiency: literature review and results of own researches
Background. The main complaint of osteoarthritis (OA) patients is a moderate or severe pain, and the drugs most frequently used to reduce it are the non-steroidal anti-inflammatory drugs. Objective: to examine the efficiency and safety of ketoprofen gel used for the treatment of knee OA patients, and also its effect on the severity of pain and improving quality of life. Materials and methods. At the premises of Clinical Physiology and Pathology of the Musculoskeletal System Department of the State Institution “D.F. Chebotarev Institute of Gerontology of the NAMS of Ukraine”, we have conducted a pilot study, which included 23 men and women aged 50–69 years with knee osteoarthritis stage 1–2. The patients were divided into two groups: group I — 13 persons whose treatment consisted of applying a thin layer of ketoprofen on the knee joint twice a day for 10 days, and group II — 10 individuals taking placebo (vaseline oil, which didn’t contain ketoprofen and active excipients) in the form of knee applications twice a day for 10 days. The study consisted of screening, visit after 10 days of therapy, and visit 20 days after discontinuation of therapy. At each visit, the intensity of pain and functional status of the knee joints were evaluated using the WOMAC scale (total score, subscales of pain, stiffness, daily activity), Lequesne index, and 15-meter test. In addition, a review of the articles from the following electronic medical databases was conducted: PubMed, Google Scholar and the Cochrane Library; there are a large amount of publications based on the effectiveness of different forms and groups of non-steroidal anti-inflammatory drugs and their comparative analysis. Results. In the group of patients who received ketoprofen we have registered: the reduction in the intensity of pain, stiffness, improvement of daily activity according to the WOMAC questionnaire subscales, and decrease of the time of the 15-meter test performance. Conclusions. Thus, ketoprofen was found to be an effective and safe agent for the local therapy of knee OA.
Valdes AM, Stocks J. Osteoarthritis and ageing. EMJ.2018;3(1):116-123.
Geenen R, Overman CL, Christensen R, et al. EULAR recommendations for the health professional’s approach to pain management in inflammatory arthritis and osteoarthritis. Ann Rheum Dis. 2018 Jun;77(6):797-807. https://doi.org/10.1136/annrheumdis-2017-212662.
Mishchenko OYa, Bereznyakov AV. Nonsteroidal anti-inflammatory drugs for topical use: analysis of evidence of effectiveness in the treatment of muscle-joint pain. In: Proceeding of the I International Scientific and Practical Conference on Current problems of pharmacotherapy and prescription of medi-cines: Medications to humans. Vol 1. 2017, March 30-31; Kharkiv, Ukraine. Kharkiv: NUPh; 2017. 204-209 pp. (in Ukrainian).
Stanos S. Osteoarthritis Guidelines: A Progressive Role for Topical NSAIDs. J Multidiscip Healthc. 2013;6:133-137. https://dx.doi.org/10.2147%2FJMDH.S35229.
Nüesch E, Dieppe P, Reichenbach S, Williams S, Iff S, Jüni P. All cause and disease specific mortality in patients with knee or hip osteoarthritis: population based cohort study. BMJ. 2011 Mar 8;342:d1165. https://doi.org/10.1136/bmj.d1165.
World Health Organization(WHO); US National Institute of Aging. Global health and ageing. Available from: https://www.who.int/ageing/publications/global_health/en/. Accessed: October 1, 2011.
Alliance for Rational Use of NSAIDs. Nonsteroidal anti-inflammatory drugs (NSAIDs): what you need to know. Available from: https://nsaidalliance.com/what-you-need-to-know/.
Rao P, Knaus EE. Evolution of nonsteroidal anti-inflammatory drugs (NSAIDs): cyclooxygenase (COX) inhibition and beyond. J Pharm Pharm Sci. 2008 Sep 20;11(2):81s-110s.
Osteoarthrosis. In: Babak OJa, editor. Semejnyj vrach. Terapevt. Racional'naja diagnostika i farma-koterapija zabolevanij vnutrennih organov. Tom 1. [Family doctor. Therapist. Rational diagnosis and pharmacotherapy of diseases of internal organs. Vol 1]. Kyiv: Zdorov`ja Ukrai'ny; 2017. Available from: http://www.dovidnyk.org/dir/12/58/759.html. (in Russian).
Kostjuk VG. Naukove obg'runtuvannja social'no-ekonomichnyh pryncypiv upravlinnja tovarnoju poli-tykoju vyrobnychyh farmacevtychnyh pidpryjemstv. Diss. kand. farm. nauk [Scientific substantiation of the socio-economic principles of managing the product policy of manufacturing pharmaceutical en-terprises. PhD diss.]. Kharkiv; 2018. 27-56 pp. (in Ukrainian).
Karateev AE. Ketoprofen in the treatment of acute and chronic pain: a review. Available from: https://www.lvrach.ru/2014/07/15436007/. Accessed: August 28, 2014. (in Russian).
Kotvitska AA, Kostiuk VH. Research of normative legal regulation of import substitution production of medicines in Ukraine. Management, Economics and Quality Assurance in Pharmacy. 2016;45(1):44-48. https://doi.org/10.24959/uekj.16.6. (in Ukrainian).
Rother M, Lavins BJ, Kneer W, Lehnhardt K, Seidel EJ, Mazgareanu S. Efficacy and safety of epicuta-neous ketoprofen in Transfersome (IDEA-033) versus oral celecoxib and placebo in osteoarthritis of the knee: multicentre randomised controlled trial. Ann Rheum Dis. 2007 Sep;66(9):1178-83. https://doi.org/10.1136/ard.2006.065128.
Dzjak GV, Stepanov JuM, Grycenko VI, Kushnirenko IV. A modern view of gastropathy caused by non-steroidal anti-inflammatory drugs. Celecoxib and the state of the secretory function of the stomach. Modern Gastroenterology. 2003;11(1):4-10. (in Ukrainian).
Maljuta LJa. Strategichne upravlinnja innovacijnym rozvytkom pidpryjemstva : navchal'nyj posibnyk [Strategic management of innovative development of an enterprise: a manual]. Ternopil: FOP Paljanycja VA; 2016. 232 p. (in Ukrainian).
El-Bogdadi D. The Untold NSAID Story. Available from: https://arapc.com/nsaid-story/.
Svintsitskyy AS. Mechanisms of therapeutic efficacy and adverse reaction of non-steroidal anti-inflammatory drugs. Praktikuucij likar. 2012;(4):5-12. (in Ukrainian).
Shatylo VB, Stadnjuk LA, Asanov EO, Pryhod'ko VJu. Features of the use of non-steroidal anti-inflammatory drugs in the elderly. Mystectvo likuvannja. 2010;68(2):13-19. (in Ukrainian).
Derry S, Conaghan P, Da Silva JA, Wiffen PJ, Moore RA. TopicalNSAIDs for chronic musculoskeletal pain in adults. Cochrane Database Syst Rev. 2016 Apr 22;4:CD007400. https://doi.org/10.1002/14651858.CD007400.pub3.
Balmaceda CM. Evolving guidelines in the use of topical nonsteroidal anti-inflammatory drugs in the treatment of osteoarthritis. BMC Musculoskelet Disord. 2014 Jan 21;15:27. https://doi.org/10.1186/1471-2474-15-27.
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 Apr;64(4):465-74. https://doi.org/10.1002/acr.21596.
Komatsu T, Sakurada T. Comparison of the efficacy and skin permeability NSAID preparations used in Europe. Eur J Pharm Sci. 2012 Dec 18;47(5):890-5. https://doi.org/10.1016/j.ejps.2012.08.016.
Sardana V, Burzynski J, Zalzal P. Safety and efficacy of topical ketoprofen in transfersome gel in knee osteoarthritis: A systematic review. Musculoskeletal Care. 2017 Jun;15(2):114-121. https://doi.org/10.1002/msc.1163.
Makris UE, Kohler MJ, Fraenkel L. Adverse effects of topical nonsteroidal antiinflammatory drugs in older adults with osteoarthritis: a systematic literature review. J Rheumatol. 2010 Jun;37(6):1236-43. https://doi.org/10.3899/jrheum.090935.
Mason L, Moore RA, Edwards JE, Derry S, McQuay HJ. Topical NSAIDs for acute pain: a meta-analysis. BMC Fam Pract. 2004 May 17;5:10. https://doi.org/10.1186/1471-2296-5-10.
Rannou F, Pelletier JP, Martel-Pelletier J. Efficacy and safety of topical NSAIDs in the management of osteoarthritis: Evidence from real-life setting trials and surveys. Semin Arthritis Rheum. 2016 Feb;45(4 Suppl):S18-21. https://doi.org/10.1016/j.semarthrit.2015.11.007.
Zeng C, Wei J, Monica S, et al. 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. Br J Sports Med. 2018 May;52(10):642-650. https://doi.org/10.1136/bjsports-2017-098043.
Copyright (c) 2020 V.V. Povoroznyuk, A.S. Musiienko, N.V. Hryb, A.A. Tkachuk
This work is licensed under a Creative Commons Attribution 4.0 International License.
© Publishing House Zaslavsky, 1997-2020