Seventeen RCTs met the review inclusion criteria and 16 (n=2,550) were included in the review (one study scored 1 on the Jadad scale and was deemed to be of insufficient quality to be included). Sample sizes ranged from 40 to 377 participants. Ten RCTs achieved a maximum Jadad score of 5 and six studies scored 3 or 4. The mean scores were 4.3 for pharmacological trials and 3.8 for non pharmacological trials. Withdrawal rates and drop-outs were reported in 14 trials; the mean drop-out rate was 10.9% in the pharmacological trials and 8.9% in non pharmacological trials.
Pharmacological treatments (12 trials):
Four RCTs that used diclofenac gel and solution (applied three or four times daily) found a benefit in favour of active treatment in reducing WOMAC scores, pain, stiffness, physical functioning, pain on walking and patient global assessment (PGA) scores. Positive results were also reported in the treatment groups of the two studies examining use of diclofenac hydroxyethylpyrrolidine plasters. Results from the two eltenac trials showed that patients with baseline visual analogue scale and Lequesne index scores above the median benefited from treatment more than those with scores below the median. The two trials of ibuprofen found a significant improvement for pain on motion in the treatment groups compared to the controls. Further results were reported.
Non pharmacological treatments (five trials):
A significant improvement in the treatment group for all outcomes measures was found for the two trials looking at CFA cream. Further results were reported.