Comparative Efficacy of Topical Meloxicam and Diclofenac in Primary Knee Osteoarthritis: a Randomized Double-Blind Controlled Trial

Osteoarthritis (OA) is a common musculoskeletal disorder characterized by joint degeneration. OA involves not only cartilage but also other joint components such as subchondral bone and synovium. OA is potentially linked to systemic inflammation. Non-pharmacological strategies are foundational in the management of OA, while medications such as acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) are also commonly prescribed. Notably, oral NSAIDs pose significant gastrointestinal adverse effects, while topically applied NSAIDs are less likely to result in side effects. Meloxicam, a selective NSAID, has shown promise in the management of osteoarthritis with its analgesic and anti-inflammatory properties, particularly in topical formulations. While osteoarthritis lacks a definitive cure, proactive medical management can mitigate further joint damage and potentially promote tissue restoration and offer hope for improved outcomes in affected individuals. This clinical trial was conducted to evaluate the efficacy of topical meloxicam 1% compared to topical diclofenac 1% in patients with primary knee osteoarthritis. Patients who met the inclusion criteria underwent a 2-week treatment regimen and applied the assigned topical preparation three times daily. Evaluation of the intensity of pain was performed by Western Ontario and McMaster Universities OA Index (WOMAC) and Visual Analog Scale (VAS) questionnaires. The quality of life and safety were also conducted throughout the study period. The results of the present study showed no significant difference between topical meloxicam and diclofenac groups in terms of WOMAC, VAS, and overall quality of life at the end of the 14th day. It appears that both topical meloxicam and diclofenac gels were equally effective in the management of OA. This clinical trial employed a formulation of topical meloxicam gel with comparable efficacy to the standard treatment of diclofenac gel. This suggests meloxicam gel as a viable alternative for pharmacological management of OA symptoms with similar efficacy to the established therapy and less systemic side effects. Trial registration: https://irct.ir/IRCT20190810044500N15 (May 05, 2021).