In patients having knee osteoarthritis, topical nimesulide gel is effective, safe and can improve quality of life.

A randomized, double-blind, placebo-controlled trial was carried to explore the safety and efficacy of topical nimesulide in patients having knee osteoarthritis.

The study recruited 74 adult knee osteoarthritis outpatients.  Participants were randomized to the treatment arm (1% topical nimesulide gel on the knee skin thrice a day) or the placebo arm (an identical-appearing gel for about 30 days). At the initial and final visit, assessment of the following parameters was done: (a) Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), (b) patient and physician global satisfaction scores, and (c) Nottingham Health Profile (NHP)

In patients receiving nimesulide, a remarkable improvement was noted in all the three parameters (pain, physical functioning, and joint stiffness) and the overall score of WOMAC between pretreatment and post-treatment values. Compared to placebo, the overall WOMAC scores were substantially better. However, pain scales, physical functioning, and stiffness did not reach statistical significance, as depicted below:

A considerable difference was witnessed between placebo and treatment groups when the alteration of WOMAC scores from the baseline was determined. Compared with placebo, nimesulide caused a considerable alteration in the overall WOMAC score. However, alteration in physical functioning, joint stiffness, and pain scales did not reach a significant level between the two interventions, as depicted below: 

The satisfaction scores of both physicians and patients were substantially improved in the treatment cohort. Only three patients (two from treatment, one from the placebo group) reported adverse effects, namely itching, which did not affect their compliance with the study.

Topical nimesulide gel improves the quality of life and appears to have beneficial effects in patients suffering from knee osteoarthritis.