Intra-articular absorption and distribution of ketoprofen after topical plaster application and oral intake in 100 patients undergoing knee arthroscopy. (Full PDF)

1.   C Rolf,

2.   B Engström,

3.   C Beauchard,

4.   L D Jacobs and

5.   A Le Liboux

+ Author Affiliations

1. 1.    Department of Orthopaedic Surgery, Huddinge University Hospital, Sweden.

Abstract

OBJECTIVE: The primary objective of this study was to assess the kinetics of ketoprofen in synovial fluid and intra-articular tissues in relation to plasma. The secondary objective was to study whether intra-articular tissues act as reservoirs.

METHODS: The ketoprofen concentration was analysed in plasma, synovial fluid and intra-articular tissues after single application of a 30 mg plaster (n = 40), multiple applications for 5 days (n = 30) or oral intake of 50 mg (n = 30) in patients undergoing knee arthroscopy.

RESULTS: Median CMax values after topical application were 12.8 ng/ml in synovial fluid, 56.7 ng/g in synovial tissue, 349.3 ng/g in meniscus and 568.9 ng/g in cartilage.

CONCLUSION: Topical applications of ketoprofen allow the attainment of high intra-articular tissue concentrations.

Topical Ketoprofen Patch (100 mg) for the Treatment of Ankle Sprain: A Randomized, Double-Blind, Placebo-Controlled Study

1. Bernard Mazières, MD*,†,
2. Stéphanie Rouanet, DESS‡,
3. Joanne Velicy, PhD‡,
4. Claudia Scarsi, PharM§, and
5. Valentina Reiner, PharB§

+Author Affiliations

1. 
   
   From the ^†Department of Rheumatology, Rangueil University Hospital, Toulouse, France, ^‡Therapharm Researches, Boulogne-Billancourt, France, and ^§Applied Pharma Research S.A., Balerna, Switzerland

1. Address correspondence to Bernard Mazières, MD, Department of Rheumatology, Rangueil University Hospital, 1, Avenue Jean-Poulhes, 31059–Toulouse Cedex 9, France (e-mail: mazieres@cict.fr).

Abstract

Background: Topical nonsteroidal anti-inflammatory drugs offer the advantage of enhanced drug delivery to local affected tissues with low plasma levels and an expected reduced incidence of systemic adverse events (mainly peptic ulcer disease and gastrointestinal hemorrhage).

Hypothesis: To test the efficacy and tolerability of a 100-mg patch of ketoprofen applied once a day.

Study Design: Randomized controlled clinical trial; Level of evidence, 1.

Methods: The 2-week trial included patients suffering painful (spontaneous pain ≥50 mm on a 0- to 100-mm visual analog scale), benign (grade I or II), recent (<2 days=”” ankle=”” sprains=”” as=”” a=”” model=”” of=”” general=”” traumatic=”” soft=”” tissue=”” injuries=”” the=”” primary=”” efficacy=”” criterion=”” was=”” spontaneous=”” pain=”” change=”” after=”” 7=”” treatment=”” in=”” intention-to-treat=”” population=”” one=”” hundred=”” sixty-three=”” patients=”” were=”” randomized=”” ketoprofen=”” 81=”” placebo=”” 82=”” span=””>

Results: After 1 week of treatment, the decrease in spontaneous pain was −50 ± 20 mm for ketoprofen and −38 ± 24 mm for the placebo, showing a statistically significant intergroup difference (P = .0007). The majority of the secondary criteria were also statistically significant in favor of the ketoprofen patch. Tolerance was good in both groups, adverse events being mostly local.

Conclusion: This trial suggested that a 7-day course of treatment with a ketoprofen patch is useful in benign ankle sprain, without revealing unexpected adverse events.

Controversies and advances in non-steroidal anti-inflammatory drug (NSAID) analgesia in chronic pain management: Review (full PDF)

Drugs Used in Transdermal Pain