Celecoxib plus topical flurbiprofen patch versus celecoxib alone for symptomatic knee osteoarthritis: a randomized controlled trial
In brief
Flurbiprofen patch plus celecoxib cuts OA pain by 1.4 points in 3 days
In a 14-day open-label trial of 90 knee-OA patients, adding a twice-daily flurbiprofen patch to standard celecoxib produced a larger drop in pain scores by day 3 (3.4 vs 2.0 on a 0-10 VAS) and sustained functional gains through two weeks. The regimen improved short-term quality-of-life measures, but the benefit did not persist beyond the first week, leaving longer-term effects unclear.
- Journal
- Rheumatology (Oxford, England) (Q1)
- Published
- 9 September 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Kaibo Sun, Min Pu, Huaixian Zhang, Liangtao Bai, Xiaoxiao Wu, Ling Fan, et al.
- PMID
- 42714961
- DOI
- 10.1093/rheumatology/keag488
Why clinicians should know about it
- Picked for Rheumatology (top studies of the week, 13 September 2026): RCT of celecoxib + topical NSAID vs celecoxib alone in
Abstract
OBJECTIVES: Rapid symptom control may facilitate earlier mobility and self-management in symptomatic knee osteoarthritis (KOA), but evidence for combining oral and topical non-steroidal anti-inflammatory drugs (NSAIDs) remains limited. This study aimed to determine whether adding a topical flurbiprofen patch to oral celecoxib provides greater short-term improvements in pain, physical function, quality of life, and patient global assessment than oral celecoxib alone in patients with symptomatic KOA. METHODS: In this open-label randomized controlled trial conducted at a tertiary academic hospital from January 2024 to March 2025, 90 patients with chronic inflammatory symptomatic KOA were randomized 1:1 to receive either oral celecoxib 200 mg once daily or celecoxib plus topical flurbiprofen patch twice daily. Outcomes were assessed at baseline and on days 3, 7, and 14. Primary outcomes were pain severity by visual analog scale (VAS) and functional impairment by WOMAC. Secondary outcomes included quality of life by SF-36 and patient global assessment (PGA). RESULTS: Eighty-nine patients completed the study (45 celecoxib; 44 combination therapy). Baseline characteristics were comparable between groups. Compared with celecoxib alone, combination therapy produced greater early pain relief, with larger VAS reductions on day 3 (3.4 ± 0.9 vs. 2.0 ± 0.8, p < 0.01) and day 7 (3.9 ± 1.0 vs. 3.3 ± 1.0, p = 0.02), but not day 14. WOMAC improvement was greater in the combination group on days 3, 7, and 14 (all p < 0.01). At day 14, SF-36 health domain scores and PGA ratings were also higher with combination therapy. CONCLUSIONS: Adding topical flurbiprofen patch to oral celecoxib provided faster early improvement in pain and function and better short-term patient-reported outcomes in symptomatic KOA. TRIAL REGISTRATION: Chinese Clinical Trial Registry: ChiCTR1800014584.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.