What is the evidence for diclofenac epolamine in the treatment of osteoarthritis of the knee?
AMSTAR Rating
Summary
Patient Population:
No information on the patient population was provided.
Intervention:
Diclofenac epolamine patch (semi-occlusive, bio-adhesive) 180 mg (corresponds to diclofenac sodium 140 mg and 50.3 mg of epolamine).
Comparison:
Treatment was compared to control/placebo conditions.
Outcome:
Onset of Pain Relief: Two RCTs are described by the review authors in which pain ratings were provided by study participants assigned to treatment and control/placebo conditions at hours 1-5. In both studies, between group differences in self-reported pain emerged at hour 3 (and continuing thereafter), with significantly greater reductions in pain experienced by individuals assigned to treatment with the diclofenac patch than to the placebo conditions. Individual absorption rates, however, appear to vary – the time taken for diclofenac to be detectable in plasma ranges from 2-8 hours. 3 small studies were included as having examined the “steady-state pharmacokinetics of the diclofenac patch” based on a twice daily application. In all trials, steady state was reach by day 3. The mean plasma concentrations did not differ during patch application from days 3 through 8 (during steady state – through last patch application on day 7) in any of the trials – suggesting that diclofenac was constantly absorbed throughout patch application.
