On comparison of the efficacy of ibuprofen with topical piroxicam, NSAIDs in topical formulation can be a safe choice for pain management in geriatric patients. This study of 139 elderly patients portrayed the effectiveness of Ibuprofen gel over piroxicam gel, along with no patients witnessing severe drug-related systemic adverse events in 72 hours.

The analgesic efficacy of topical ibuprofen and topical piroxicam was compared in this prospective, randomized, controlled, double-blinded study for acute musculoskeletal injuries in geriatric patients.

Elderly patients were allocated to groups: topical ibuprofen (in 70 patients) group or topical piroxicam (in 69 patients) group. The initial dose of gel was applied in the casualty department and then was used at home by the patients three times a day for 3 days.

The initial baseline visual analogue scale (VAS) score at V0 was compared with the VAS scores at different time points- V1, V2, V3 and v4 i.e. at 60 minutes, 120 minutes, 24 hours and 72 hours, respectively for each patient. An assessment of VAS scores reductions, clinical efficacy and adverse events was done.

VAS scores were significantly lower at each time point compared to baseline in the ibuprofen group (V0 –V: 1.08; V0 –V2: 1.09; V0 –V3: 1.44; V0 –V4: 1.59). The mean VAS score are portrayed in the following figure 1:

The reduction in the VAS scores (in mean %) with the application of topical ibuprofen gel was considerably greater compared to with piroxicam gel. The ibuprofen gel group had a significantly higher clinical effect of treatment.

No significant difference in treatment-linked adverse events amongst the groups was found.

Ibuprofen gel is more clinically effective as compared to piroxicam gel in elderly patients.