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Topically applied diclofenac (Voltaren) gel is FDA-approved for treating osteoarthritic pain, particularly in the knees and hands. In this industry-sponsored randomized trial, 385 patients with moderate osteoarthritic pain in the dominant hand received diclofenac gel (4 times daily for 8 weeks) or placebo (the vehicle gel without diclofenac). All patients showed radiographic evidence of osteoarthritis at an interphalangeal joint or at the thumb carpometacarpal joint.
Patients rated their symptoms on a pain intensity scale, a combined pain-stiffness-function index, and a global rating scale. For each of these 3 outcomes, topical diclofenac was better than placebo by about 5 to 7 points (on 100-point scales) at weeks 4, 6, and 8. Some differen…