The objective of this article is to review published clinical data on
diclofenac epolamine topical patch 1.3% (
DETP) in the treatment of acute
soft tissue injuries, such as strains,
sprains, and
contusions. Review of published literature on topical nonsteroidal anti-inflammatory drugs (
NSAIDs),
diclofenac, and
DETP in patients with acute
soft tissue injuries was included. Relevant literature was identified on MEDLINE using the search terms topical
NSAIDs,
diclofenac,
diclofenac epolamine,
acute pain,
sports injury,
soft tissue injury, strain,
sprain, and
contusion, and from citations in retrieved articles covering the years 1978-2008. Review of published, randomized clinical trials and meta-analyses shows that topical
NSAIDs are significantly more effective than placebo in relieving
acute pain; the pooled average relative benefit was 1.7 (95% confidence interval, 1.5-1.9). In a limited number of comparisons, topical and oral
NSAIDs provided comparable
pain relief, but the use of topical agents produced lower plasma
drug concentrations and fewer systemic adverse events (AEs). The physical-chemical properties of
diclofenac epolamine make it well suited for topical use. In patients with acute
soft tissue injuries treated with
DETP, clinical data report an
analgesic benefit within hours of the first application, and significant
pain relief relative to placebo within 3 days. Moreover,
DETP displayed tolerability comparable with placebo; the most common AEs were
pruritus and other application site reactions. Review of published literature suggests that
DETP is generally safe and well tolerated, clinically efficacious, and a rational treatment option for patients experiencing
acute pain associated with strains,
sprains, and
contusions, and other localized painful conditions.