Oral non-steroidal anti-inflammatories drugs (NSAIDs) are effective in pain relief in osteoarthritis (OA), but are also associated with risks of adverse systemic side effects. In order to reduce its toxicity, it would be desirable to decrease the plasmatic levels of NSAIDs since those side effects are dose-dependent. Topical NSAIDs would be a therapeutic alternative in theory, because while they reach high levels in local tissues, they also produce low plasmatic levels. Our review analyzed clinical randomized and shown that topical NSAIDs were superior to placebo and have similar efficacy to oral NSAIDs, but due a few number of trials and methodological weaknesses we can't make definitive conclusions. Further well designed, long term studies are required.
topical NSAIDs; osteoarthritis; clinical trials
