AB0877 CLINICAL EFFICACY AND SAFETY PROFILE OF TOPICAL ETOFENAMATE IN THE TREATMENT OF PATIENTS WITH MUSCULOSKELETAL DISORDERS: RESULTS OF A SYSTEMATIC REVIEW

Background:Musculoskeletal disorders affect millions of people of all ages around the world [1]. Nonsteroidal anti-inflammatory drugs (NSAIDs) are, in general, the cornerstone of musculoskeletal pain management; however, systemic adverse events with oral formulations of NSAIDs are common. To address this, topical formulations of some NSAIDs have been developed. [2] Although there are many nonsteroidal anti-inflammatories, only a few are used as local therapeutics. This is because the physicochemical properties of these substances, which were originally developed for oral administration, frequently do not guarantee a satisfactory pharmaceutical formulation with satisfactory topical absorption. [3]Objectives:The aim of this systematic review was to assess the available evidence on the efficacy and safety of the topical formulations of the NSAID etofenamate in patients with musculoskeletal disorders.Methods:A systematic search of PubMed and Web of Science was conducted, using the key words (topical etofenamate efficacy) OR (topical etofenamate safety) OR (topical etofenamate effectiveness) to identify studies of etofenamate published from inception to November 2018. Some published manuscripts of interest known by the authors but not identified in the PubMed search were also added to ensure the review article was as comprehensive as possible.Results:Overall, 12 studies were identified. [3-14] These studies demonstrated the ability of topical etofenamate (administered either in gel [5% or 10%], cream [10%] or lotion [10%] formulations]) to improve pain and reduce inflammation in patients with musculoskeletal disorders, including blunt injuries and rheumatic diseases. Etofenamate was shown to have an overall efficacy that was superior to other topical NSAIDs, such as 1% indomethacin and 1% diclofenac, and to be as effective as topical formulations of 2.5% ketoprofen gel and 2% ketorolac gel (although ketorolac suggested a better elimination of pain at some time points). Overall, when compared to placebo, etofenamate gel 5% demonstrated significant better results in the reduction of pain symptoms (with or without combination with ultraphonophoresis). Furthermore, clinical evidence indicates that etofenamate is generally well tolerated in these indications.Conclusion:The available clinical evidence suggests that etofenamate could be an effective therapeutic option for the management of musculoskeletal disorders, such as blunt traumas, lumbago or osteoarthritis. However, larger and well-controlled clinical trials comparing the efficacy and safety of etofenamate with other newer topical NSAIDs are warranted.References:[1]Atchison JW, et al. J Manag Care Pharm. 2013; 19: S3-19.[2]Haroutiunian S, et al. Pain Med. 2010; 11: 535-49.[3]Pelster B, et al. ZFA. 1992; 68: 364-7.[4]Schneider H. Therapiewoche. 1983;33:5809-18.[5]Miehlke RK, et al. Med Welt. 1985;36:103-6.[6]Rechziegler H, et al. Therapiewoche. 1986;36:5347-51.[7]Hallmeier B. Rheuma. 1988;8:183-6.[8]Rechziegler H. Therapiewoche. 1983;33:703-7.[9]Matsuno S, et al. J Med Pharm Sci. 1983;9:349-67.[10]Nagaya I, et al. Med Pharmacy. 1982;8:1549-82.[11]Ascher R, et al. Fortschr Med. 1982;37:1729-34.[12]Billigmann P, et al. Praktische Traumatologie Sportmedizin. 1992;2:72-7.[13]Diebschlag W, et al. J Clin Pharmacol. 1990;30:82-9.[14]Matucci-Cerinic M, et al. Int J Clin Pharmacol Res. 1988;8:157-60Disclosure of Interests:Anabela Pereira Consultant of: Recently, I was a paid consultant of Bial., Speakers bureau: I have been a paid speaker for Bial., Daniela Marinho Employee of: I’m currently an employee of BIAL pharmaceutical company. I belong to the medical affairs department of Bial.