A COMPARATIVE STUDY OF EFFICACY AND SAFETY OF ORAL DICLOFENAC AND DECREASED DOSE OF DICLOFENAC PLUS TOPICAL DICLOFENAC IN TREATMENT OF KNEE OSTEOARTHRITIS

Objectives: To compare efficacy and safety of topical plus reduced dose of   diclofenac to oral diclofenac in therapeutic dose. Method: The study was prospective, comparative and randomized, which included 50 patients suffering from knee osteoarthritis. Patients were randomized to receive either – oral diclofenac alone (50 mg thrice daily) (therapy1) or decreased dose of oral diclofenac and topical diclofenac (75 mg SR once daily + 10 mg Nanogel thrice daily) (therapy 2). The patients had been followed up for 7 days. Visual Analogue Scale and Lequesne Index has been used to evaluate the efficacy. Adverse drug reaction form, WHO and Naranjo Causality Assessment Scale were used to evaluate the safety of the patients. Data were analyzed by independent student t- test. Results: Out of 50 patients 17 were male and 33 were female.  Osteoarthritis is more prevalent in 40-60 years of age, female patients and higher body weight and Body Mass Index (BMI). Therapy 2 was found statistically superior to therapy 1 on efficacy parameters (VAS Scale and Lequesne Index). Compliance was also better with therapy 2. Conclusion: Both therapies effective and well tolerated although therapy 2 is comparatively more effective and has more patient compliance than therapy 1. There was no ADR reported.