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Ketoprofen managed rheumatic pain more effectively than ibuprofen, diclofenac
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Ketoprofen displayed significantly greater efficacy in relieving moderate to severe pain and improving function in patients with rheumatic diseases when compared with ibuprofen or diclofenac, according to study results.
Researchers in Italy used Cochrane Collaboration guidelines to systemically review randomized clinical trials (RCTs) from Medline and Embase databases up to June 2011 to compare the efficacy of oral ketoprofen (50 mg/day to 200 mg/day) with ibuprofen (600 mg/day to 1,800 mg/day) or diclofenac (75 mg/day to 150 mg/day).
Eight hundred ninety-eight patients were included in 13 RCTs that met inclusion criteria and compared ketoprofen with ibuprofen (n=8) or diclofenac (n=5).
Five hundred forty-four patients included in nine RCTs had rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, low back pain or painful shoulder. Doses ranged from 150 mg to 200 mg, ketoprofen; 800 mg to 1,800 mg, ibuprofen; and 75 mg to 150 mg, diclofenac. Treatment duration ranged from one dose to 3 months.
At all point-estimates of the mean weighted size effect, the difference between ketoprofen and pooled data for ibuprofen and diclofenac was statistically significant (0.459; 95% CI, 0.33-0.58). Ketoprofen also displayed significant superiority to diclofenac (mean=0.422; 95% CI, 0.19-0.65) and ibuprofen (mean=0.475; 95% CI, 0.32-0.62) at all point-estimates. In meta-analyses, the test of heterogeneity for the efficacy outcome was not statistically significant (P=.219).
“The results of the meta-analysis showed a statistically significant difference in efficacy in favor of ketoprofen,” the researchers reported. “The multiplicity of currently available nonsteroidal anti-inflammatory drugs [NSAIDs] provides a strong rationale for comparing their risk/benefit ratios in order to help physicians make rational therapeutic choices for managing pain,” the researchers reported. “Taken together, the findings … show that ketoprofen is more efficacious than diclofenac/ibuprofen, and doctors should take this into consideration when choosing NSAIDs.”
Disclosure: All researchers received consultancy fees or congress invitations from Dompé SpA, which financially supported the study.
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