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Low-dose diclofenac in the treatment of osteoarthritis: A 1-year, open-label, Phase III safety study.

Low-dose diclofenac in the treatment of osteoarthritis: A 1-year, open-label, Phase III safety study. Low-dose diclofenac in the treatment of osteoarthritis: A 1-year, open-label, Phase III safety study.
Low-dose diclofenac in the treatment of osteoarthritis: A 1-year, open-label, Phase III safety study. Low-dose diclofenac in the treatment of osteoarthritis: A 1-year, open-label, Phase III safety study.

Diclofenac is used for the treatment of osteoarthritis (OA); however, like other nonsteroidal anti-inflammatory drugs (NSAIDs) it can be associated with serious dose-related adverse events (AEs).

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Key take away

This research article deals with potency of low-dose SoluMatrix diclofenac. The safety of SoluMatrix diclofenac was similar to findings for other diclofenac drug products. Long term studies should be followed to draw the long term benefits. 

Background

Diclofenac is used for the treatment of osteoarthritis (OA); however, like other nonsteroidal anti-inflammatory drugs (NSAIDs) it can be associated with serious dose-related adverse events (AEs). Low-dose diclofenac has been developed to provide efficacy at lower diclofenac doses. A recently published Phase III study evaluated the efficacy and safety of diclofenac 35 mg twice daily (b.i.d.) and thrice daily (t.i.d.) in patients with OA pain treated for 12 weeks.

Method

This Phase III multicenter, open-label study assessed the safety of diclofenac in patients with OA dosed up to 52 weeks (ClinicalTrials.gov: NCT01510912). The study enrolled 602 chronic NSAID/acetaminophen users, aged ≥40 years with OA of the knee or hip. Patients received diclofenac 35 mg b.i.d., which could be increased to t.i.d. and subsequently reduced to b.i.d. as needed. Safety assessments included AEs, vital signs, physical examination findings, 12-lead electrocardiogram, and clinical laboratory test results. Patient-reported outcomes were evaluated by the Short Form-36 (SF-36).

Result

A total of 601 patients received diclofenac; 373 of 601 patients (62.1%) received treatment for ≥11 months. The most frequent AEs included upper respiratory tract infection, headache, urinary tract infection, diarrhea, nasopharyngitis, and nausea. Serious gastrointestinal, cardiovascular, renal, and hepatic AEs were uncommon. A small proportion (99 patients, 16.5%) of patients discontinued participation in the study due to AEs. Clinically meaningful improvements from baseline in Physical Component Summary Scores of the SF-36 were noted at week 12 and were sustained through week 52. Improvements in six of the eight individual physical and mental SF-36 domains were also noted.

Conclusion

Diclofenac treatment for up to 1 year was generally well tolerated in patients with OA pain and associated with improvement in quality of life measures.

Source:

Postgrad Med. 2015 Jun;127(5):517-28

Article:

Low-dose SoluMatrix diclofenac in the treatment of osteoarthritis: A 1-year, open-label, Phase III safety study.

Authors:

Altman RD et al.

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