Abstract
The diclofenac epolamine topical patch 1.3% was designed to deliver analgesic concentrations
of diclofenac to an underlying soft tissue injury site, while limiting systemic exposure
to diclofenac. This randomized, double-blind, placebo-controlled study evaluated the
safety and efficacy of the diclofenac epolamine topical patch for the treatment of
acute pain due to minor soft tissue injury. Patients (18–65 years, inclusive) with
clinically significant minor soft tissue injuries (mild or moderate sprain, strain,
or contusion) incurred within 7 days of study entry and having pain scores ≥5 on a
Visual Analog Scale of 0–10 were enrolled. Patients were randomized to receive the
diclofenac epolamine topical patch (n=207) or placebo patch (n=211) application twice
daily for 14 days or until pain resolution. Patients recorded pain scores every 12 h
at the time of patch removal using the Visual Analog Scale. Investigator-assessed
global response to therapy was also evaluated. Safety data were collected throughout
the study. Twice-daily treatment with diclofenac epolamine topical patch produced
a statistically significant reduction in mean pain score relative to baseline by an
additional 18.2% in the diclofenac epolamine topical patch group (0.435±0.268) compared
with the placebo group (0.532±0.293) (p=0.002; overall) beginning after application
of the second patch. Consistent with this treatment effect, median time to pain resolution
was shortened by 2 days in the diclofenac epolamine topical patch group relative to
the placebo group (p=0.007). These results were reinforced independently by investigators
who reported treatment as good or excellent for 58% of diclofenac epolamine topical
patch-treated patients compared with 49% in the placebo patch group (p=0.008). The
most common adverse events were treatment site related (n=16, 7.9% diclofenac epolamine
topical patch; n=12, 5.8% placebo patch). Most (80%) patients reported tolerability
as excellent or good. In conclusion, the diclofenac epolamine topical patch provides
effective, rapid pain relief for the treatment of acute pain from minor soft tissue
injury and appears generally safe and well tolerated.
Key words
acute pain treatment - clinical trial - diclofenac topical patch - musculoskeletal
injury - NSAID
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Correspondence
Dr. Kerry KuehlMD
Oregon Health & Science
University
Division of Health Promotion &
Sports Medicine
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