Efficiency of the combination of physical therapy modalities with topical nonsteroidal anti-inflammatory drugs for treatment of pain in rheumatology

  • O. A. Kapeltsova National Pirogov Memorial Medical University, Vinnytsia
  • O. V. Dolynna National Pirogov Memorial Medical University, Vinnytsia
  • N. V. Shkolina 2Vinnytsia Regional Clinical Hospital Named after M. I. Pirogov
  • O. V. Marchuk National Pirogov Memorial Medical University, Vinnytsia
Keywords: anti-inflammatory agents, non-steroidal, ketoprofen, physical therapy modalities, electrophoresis, phonophoresis

Abstract

Pain is the most common syndrome in rheumatology. NSAIDs are often used in its treatment. But they have limitations associated with side effects. An advantage of topical drugs and physical factors (electrophoresis, phonophoresis) combination is the use of low doses of the drug and a decrease in time, to achieve a therapeutic effect, reduce the risk of adverse reactions, increase the concentration of the drug in the inflammation focus, prolonged action (creating a drug depot in tissues). Ketoprofen gel (“Artrocol gel”) is one of the representatives of this pharmacological group. Physicochemical properties help ketoprofen to penetrate easily through the skin and create a therapeutic concentration in the underlying tissues.

Objective.

To assess the effectiveness of ketoprofen gel (“Arthrocol gel”) electrophonophoresis in the treatment of pain in rheumatological patients.

Materials and methods.

The study was carried out on the basis of Physiotherapy Department of Vinnytsia Regional Clinical Hospital named after M. I. Pirogov. All patients treated according to the unified clinical protocols were divided into experimental group (EG) and control group (CG). Patients of EG (98 persons) underwent electrophonophoresis with ketoprofen gel once a day for a week. In CG (43 persons) ketoprofen gel was used without electrophonophoresis. The intensity of the pain syndrome is monitored using a visual analog scale (VAS) of Huskisson at rest and during movement. A week later, the patient and the doctor evaluated satisfaction with the results of treatment on the scale: not effective, insufficient, satisfactory, good, excellent.

Results.

There was a persistent decrease in the intensity of pain syndrome in patients of both groups. The VAS scores were lower in the EG starting from the 3rd day of treatment. The intensity of the acute pain syndrome after 1-week treatment at rest (t = 4.71, p < 0.001) and during the movement (t = 3.84,  p < 0.001) more decrease in EG. Satisfaction with the results of treatment was higher in EG.

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References

Report of the American College of Rheumatology Pain Management Task Force // Arthritis Care & Research. – 2010. – 62 (5). – P. 590–599.

Duenas M. A review of chronic pain impact on patients, their social environment and the health care system / Duenas M., Ojeda B., Salazar A., Mico J. and Failde I. // Journal of Pain Research. – 2016. – Vol. 9. – P. 457–467.

Sarzi-Puttini P. The impact of pain on systemic rheumatic diseases / Sarzi-Puttini P., Atzeni F., Clauw D. and Perrot S. // Best Practice & Research Clinical Rheumatology. – 2015. – 29 (1). – P. 1–5.

Matcham F. The impact of rheumatoid arthritis on quality-of-life assessed using the SF-36: A systematic review and meta-analysis / Matcham F., Scott I., Rayner L. et al. / Seminars in Arthritis and Rheumatism. – 2014. – 44 (2). – P. 123–130.

Roux C. Impact of musculoskeletal disorders on quality of life: an inception cohort study / Roux C. // Annals of the Rheumatic Diseases. – 2005. – 64 (4). – P. 606–611.

Фізіотерапевтичні та фізіопунктурні методи і їх практичне застосування : навчально-методичний посібник. – 2-ге вид., доп. – К. : Купріянова О. О., 2004. – С. 316.

Compendium.com.ua. АРТРОКОЛ гель / World Medicine / Инструкция по применению, цена в аптеках, состав, показания / Компендиум. – [online] Available at: https:// compendium.com.ua/info/220040/artrokol-gel_/ – [Accessed 10 Jan. 2018].

Asbill C. Enhancement of Transdermal Drug Delivery: Chemical and Physical Approaches / Asbill C., El-Kattan A. and Michniak B. // Critical Reviews in Therapeutic Drug Carrier Systems. – 2000. – 17 (6). – P. 64.

McAlindon T. OARSI guidelines for the non-surgical management of knee osteoarthritis / McAlindon T., Bannuru R., Sullivan M. et al. // Osteoarthritis and Cartilage. – 2014. – 22 (3). – P. 363–388.

Ross A. Hauser. The Acceleration of Articular Cartilage Degeneration in Osteoarthritis by Nonsteroidal Anti-inflammatory Drugs / Ross A. Hauser // Journal of Prolotherapy. – 2010. – 2 (1). – P. 305–322.

Бур’янов О. А. Лікування остеоартрозу в рамках доказової медицини / Бур’янов О. А., Омельченко Т. М. // Здоров’я України [Ортопедія/доказова медицина]. – 2011. – С. 12–14.

Tashiro Y. Iontophoretic Transdermal Delivery of Ketoprofen. Effect of Iontophoresis on Drug Transfer from Skin to Cutaneous Blood / Tashiro Y., Kato Y., Hayakawa E., Ito K. // Biological & Pharmaceutical Bulletin. – 2000. – 23 (12). – P. 1486–1490.

Shinkai N. Intra-articular penetration of ketoprofen and analgesic effects after topical patch application in rats / Shinkai N., Korenaga K., Mizu H. and Yamauchi H. // Journal of Controlled Release. – 2008. – 131 (2). – P. 107–112.

Panus P. C. Ketoprofen Tissue Permeation in Swine Following Cathodic Iontophoresis / Panus P. C., Ferslew K. E., Tober-Meyer B., Kao R. L. // Physical Therapy. – 1999.

Cao M. Formulation Optimization and Ex Vivo and In Vivo Evaluation of Celecoxib Microemulsion-Based Gel for Transdermal Delivery / Cao M., Ren L. and Chen G. // AAPS PharmSciTech. – 2016. – 18 (6). – P. 1960–1971.

Yildiz N. Comparison of ultrasound and ketoprofen phonophoresis in the treatment of carpal tunnel syndrome / Yildiz N., Atalay N., Gungen G., Sanal E., Akkaya N. and Topuz O. // Journal of Back and Musculoskeletal Rehabilitation. – 2011. – 24 (1). – P. 39–47.

Cagnie B. Phonophoresis Versus Topical Application of Ketoprofen: Comparison Between Tissue and Plasma Levels / Cagnie B., Vinck E., Rimbaut S., Vanderstraeten G. // Physical Therapy. – 2003. – 83 (8). – P. 707–712.

Dakowicz A. Application of Ketoprofen Gel in the Treatment of Locomotor System / Dakowicz A., KuryliszynMoskal A., Bialowiezec M., Chorazy M., Jablonowska I. // Pain. – 2017. – 59 (1). – P. 27–34.

Pérez-Merino L. Evaluation of the effectiveness of three physiotherapeutic treatments for subacromial impingement syndrome: a randomised clinical trial / Pérez-Merino L., Casajuana M., Bernal G. et al. // Physiotherapy. – 2016. – 102 (1). – P. 57–63.

Hasan T. De Quervain’s Tenosynovitis and Phonophoresis: A Randomised Controlled Trial in Pregnant Females / Hasan T. and Fauzi M. // Journal of Orthopaedics, Trauma and Rehabilitation. – 2015. – 19 (1). – P. 2–6.

Koeke P. Comparative study of the efficacy of the topical application of hydrocortisone, therapeutic ultrasound and phonophoresis on the tissue repair process in rat tendons / Koeke P., Parizotto N., Carrinho P. and Salate A. // Ultrasound in Medicine & Biology. – 2005. – 31 (3). – P. 345– 350.

Souza J. Effect of Phonophoresis on Skin Permeation of Commercial Anti-inflammatory Gels: Sodium Diclofenac and Ketoprofen / Souza J., Meira A., Volpato N. et al. // Ultrasound in Medicine & Biology. – 2013. – 39 (9). – P. 1623–1630.

Panus P. Transdermal iontophoretic delivery of ketoprofen through human cadaver skin and in humans / Panus P., Campbell J., Kulkarni S. et al. // Journal of Controlled Release. – 1997. – 44 (2–3). – P. 113–121.

Барскова В. Г. Место локальной терапии в ревматологи. В фокусе – гель кетопрофен / Барскова В. Г., Ильина А. Е. // Современная ревматология. – 2008. – 3. – C. 74–77.

Adachi H. Physical characteristics, pharmacological properties and clinical efficacy of the ketoprofen patch: a new patch formulation / Adachi H., Ioppolo F., Paoloni M., Santilli V.// European Review for Medical and Pharmacological Sciences. – 2011. – 15. – P. 823–830.

Колісник П. Ф. Лекції з клінічної вертебрології : навчальний посібник / Колісник П. Ф. – Вінниця : 2017. – С. 184.

Tezel, A. and Mitragotri S. Interactions of Inertial Cavitation Bubbles with Stratum Corneum Lipid Bilayers during Low-Frequency Sonophoresis / Tezel, A. and Mitragotri S. // Biophysical Journal. – 2003. – 85 (6). – P. 3502–3512.

Tezel A. Investigations of the role of cavitation in low frequency sonophoresis using acoustic spectroscopy / Tezel A., Sens A. and Mitragotri S. // Journal of Pharmaceutical Sciences. – 2002. – 91 (2). – P. 444–453.

Lennart D. Johns. Nonthermal Effects of Therapeutic Ultrasound: The Frequency Resonance Hypothesis / Lennart D. Johns // Journal of Athletic Training. – 2002. – 37 (3). – P. 293–299.

Published
2018-03-07
How to Cite
Kapeltsova, O. A., O. V. Dolynna, N. V. Shkolina, and O. V. Marchuk. 2018. “Efficiency of the Combination of Physical Therapy Modalities With Topical Nonsteroidal Anti-Inflammatory Drugs for Treatment of Pain in Rheumatology”. Medicina Bolu 3 (1), 49-55. https://doi.org/10.31636/pmjua.v3i1.87.
Section
Original article