Comparative evaluation of the effectiveness of parenteral and oral forms of diclofenac sodium and meloxicam in patients with symptomatic osteoarthritis of the knee joints

Nonsteroidal anti-inflammatory drug are considered at the cornerstone drug therapy for osteoarthritis (OA) because their main function is to relieve pain and reduce inflammation. The aim of the study was to compare the efficacy of treatment of patients with symptomatic knee osteoarthritis (KOA) using the diclofenac sodium and meloxicam. Materials and methods. The study included 40 females aged 50–75 years with symptomatic KOA, and were divided into 2 groups: group I — 20 subjects receiving diclofenac sodium; group II — 20 subjects receiving meloxicam. The intensity of the pain syndrome and the functional of the knee were assessed using the WOMAC scale, the four-component VAS, the Lequesne index, and functional tests at each visit. The safety of medication was determined by the frequency adverse events. Results. Patients of two groups did not differ by age and initial level of knee pain. During the treatment, patients in both groups showed a reduction of pain intensity by VAS on 5 and 20 days of therapy (p<0.01) without significant difference between groups, however in the subjects of group I the level of pain intensity by VAS on days 2 and 3 of treatment was significantly lower compared to group II (p = 0.003 and p = 0.03, respectively). In patients of both groups were revealed a significant reduction of pain, stiffness and physical function by WOMAC subscales on 5 and 20 days of treatment, but in group I the intensity of pain after 5 days of treatment was significantly lower (t = 2.8, p < 0.004) compared to group II. Conclusions. The treatment of patients with knee OA using the diclofenac sodium and meloxicam is effective, but in the case of diclofenac sodium analgesic effect were faster, already on 2 and 3 days of treatment were detected significantly lower pain intensity by VAS and on 5 days by WOMAC pain subscale.