Received:9 December 2022 Accepted:11 March 2023D0t10.1002/jor.25549RESEARCH ARTICLErthopaedicResearchTopical nonsteroidal anti-inflammatory drugs formanagement of osteoarthritis pain:A consensusrecommendationJoon-Kiong Lee1 Azlina A.Abbas2 Tien-Eang Cheah3Ruslan Nazaruddin Simanjuntak4 Sargunan Sockalingam5 Sharifah RoohiBeacon Hospital,Petaling Jaya,Malaysia2National Orthopaedic Centre of ExcellenceAbstractfor Research and Leaming (NOCERAL).Osteoarthritis(OA)contributes to significant medical and socioeconomic burden inUniversiti Malaya,Kuala Lumpur,Malaysiamany populations.Its prevalence is expected to rise continuously owing to the3Rheumatology Unit.Pantai Hospital,KualaLumpur,Malaysiacombined effects of aging and increase in risk factors,including obesity,physicalALTY Hospital,Kuala Lumpur,Malaysiainactivity,and joint injuries.Pain is a hallmark presentation of OA.TopicalSRheumatology Unit,Universiti Malayanonsteroidal anti-inflammatory drugs (NSAIDs)are recommended by manyMedical Centre,Kuala Lumpur,Malaysiainternational guidelines as an early treatment option of the management ofHand&Upper Limb Centre.Pantai Hospital,osteoarthritic pain.However,the use of topical NSAIDs remains low in MalaysiaKuala Lumpur,Malaysiaand appears not to be a preferred agent in managing OA pain by prescribers.There isCorrespondencealso limited guidance from local medical bodies on the use of topical NSAIDs toJoon-Kiong Lee,Beacon Hospital,No.1,Jalan215,Off Jalan Templer,Section 51,46050manage OA pain.This consensus recommendation is intended to serve as a practicalPetaling Jaya,Malaysia.guide for healthcare practitioners on the use of topical NSAIDs in the managementEmail:osteoporosis_jklee@yahoo.comof OA pain.Eight statements and recommendations were finalized covering theFunding informationareas of OA burden,topical NSAIDs formulations,safety and efficacy of topicalHoe Pharmaceutical Sdn BhdNSAIDs,and patient education.Robust evidence is available to support the efficacyand safety of topical NSAIDs,with its benefits further strengthened by ease of useand access.Taking these into consideration,we recommend that healthcarepractitioners advocate for the early use of topical NSAIDs over oral NSAIDs formild-to-moderate OA pain,while engaging in a shared decision-making process withpatients for optimal clinical outcomes.KEYWORDSconsensus development,nonsteroidal anti-inflammatory drugs,osteoarthritis,pain management,topical administrationThis is an open access article under the terms of the Creative Commons Attribution License,which permits use,distribution and reproduction in any medium,provided the original work is properly cited.2023 The Authors.Joumal of Orthopoedic Research published by Wiley Periodicals LLC on behalf of Orthopaedic Research Society.J Orthop Res.2023:1-9.wileyonlinelibrary.com/joumal/jor1
