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Topical diclofenac beats oral formulation in safety, tolerability
Topical diclofenac is safer and better tolerated by patients with osteoarthritis of the knee compared with the oral formulation, according to data presented here at annual meeting of the American Academy of Pain Medicine, in National Harbor, Md.
Topical diclofenac (TDiclo) is safer and better tolerated by patients with osteoarthritis (OA) of the knee compared with the oral formulation (ODiclo), according to data presented here at annual meeting of the American Academy of Pain Medicine, in National Harbor, Md. In addition, it is associated with significantly fewer GI-related adverse events.
Data from two 12-week, double-blind, randomized, controlled, multicenter trials comparing the safety and efficacy of TDiclo and ODiclo in 927 patients with knee OA were pooled and analyzed. Only patients who received either TDiclo alone (40 to 50 drops, 3 to 4 times daily) or ODiclo alone (50 mg to 100 mg, 1 to 3 times daily) were included in the analysis.
Significantly more patients treated with ODiclo discontinued the study due to GI-related adverse events (14.5% vs 5.8%, respectively; P<.0001). Overall, serious adverse events occurred in more patients treated with ODiclo compared with TDiclo (8 vs 1, respectively), but there were no statistically significant differences in the overall incidence of serious adverse events. One gastric ulcer hemorrhage was reported in a patient receiving ODiclo. No patient receiving TDiclo experienced a GI-related serious adverse event.
Acute myocardial infarction and coronary artery disease occurred in 3 patients; myocardial infarction in 2 patients treated with ODiclo, and arteriosclerosis in 1 patient treated with TDiclo.
Clinically significant elevations in alanine aminotransferase were reported in more patients receiving ODiclo compared with TDiclo (4.1% vs 1.2%, respectively; P<.01). Liver enzyme levels and creatinine were significantly increased in patients treated with ODiclo (P<.001), and creatinine clearance (P<.0001) and hemoglobin (P<.0001) were significantly increased.
“Overall, these results suggest that due to its increased localized diclofenac absorption with very low systemic levels, TDiclo may yield comparable efficacy to that of ODiclo with significantly less risk of serious GI-related adverse events,” said lead author Sanford H. Roth, MD, medical director, Arizona Research and Education, and adjunct professor, Arthritis Research Lab, Arizona State University, Phoenix, Az.
These studies were supported by Nuvo Research Inc., and Dimethaid Healthcare Ltd. Editorial, and funded by Covidien. Dr. Roth is a stockholder in Transdel Pharmaceuticals and a consultant and speaker for Covidien.
Coalition promotes important acetaminophen dosing reminders
November 18th 2014It may come as a surprise that each year Americans catch approximately 1 billion colds, and the Centers for Disease Control and Prevention estimates that as many as 20% get the flu. This cold and flu season, 7 in 10 patients will reach for an over-the-counter (OTC) medicine to treat their coughs, stuffy noses, and sniffles. It’s an important time of the year to remind patients to double check their medicine labels so they don’t double up on medicines containing acetaminophen.
Support consumer access to specialty medications through value-based insurance design
June 30th 2014The driving force behind consumer cost-sharing provisions for specialty medications is the acquisition cost and not clinical value. This appears to be true for almost all public and private health plans, says a new report from researchers at the University of Michigan Center for Value-Based Insurance Design (V-BID Center) and the National Pharmaceutical Council (NPC).
Management of antipsychotic medication polypharmacy
June 13th 2013Within our healthcare-driven society, the increase in the identification and diagnosis of mental illnesses has led to a proportional increase in the prescribing of psychotropic medications. The prevalence of mental illnesses and subsequent treatment approaches may employ monotherapy as first-line treatment, but in many cases the use of combination of therapy can occur, leading to polypharmacy.1 Polypharmacy can be defined in several ways but it generally recognized as the use of multiple medications by one patient and the most common definition is the concurrent use of five more medications. The presence of polyharmacy has the potential to contribute to non-compliance, drug-drug interactions, medication errors, adverse events, or poor quality of life.
Medical innovation improves outcomes
June 12th 2013I have been diagnosed with stage 4 cancer of the pancreas, a disease that’s long been considered not just incurable, but almost impossible to treat-a recalcitrant disease that some practitioners feel has given oncology a bad name. I was told my life would be measured in weeks.
