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Acute Pain | Chronic Pain | General

Nabumetone for treating skin and soft tissue injury

Clinical bottom line:

Based on a small number of trials, nabumetone is as effective as other NSAIDs in relieving pain and inflammation resulting from skin and soft tissue injury. It does not appear to be associated with significant side-effects.


Nabumetone

Nabumetone (Relifex) is a non-steroidal anti-inflammatory drug (NSAID), and a relatively weak inhibitor of prostaglandin synthesis. Its principle metabolite is a potent inhibitor of prostaglandin synthesis. Main indications are for osteoarthritis and rheumatoid arthritis. NSAIDs are also used in the treatment of skin and soft tissue injury

Systematic review

Jenner PN. Nabumetone in the treatment of skin and soft tissue injury. American Journal of Medicine 1987; 83(suppl 4B):101-106

Open and double-blind trials were included in the review. Only double-blind trials are considered here.

Inclusion criteria were double-blind controlled trials of nabumetone; skin or soft tissue injury; adult patients; drug administration by 48 hours post-injury (max. one week); non-severe injury; dosing regime 2 g loading dose followed by 1 g twice daily for seven days. Randomisation of trials not stated.

Assessment of recovery was by physician at seven days.

Findings

Three trials met inclusion criteria.

Nabumetone versus placebo

One trial was included. Physician assessment of recovery showed no significant difference; 82% of nabumetone patients and 84% of placebo patients had good recovery at seven days.

Nabumetone versus ibuprofen.

One trial met criteria. Comparison was nabumetone versus 800 mg ibuprofen followed by 400 mg 4 x daily. There were no significant differences between nabumetone and ibuprofen for measures of pain, swelling or limitation of function.

Nabumetone versus naproxen.

One trial met criteria. Comparison was nabumetone 1 g nightly vs. 500 mg naproxen given twice daily, up to 14 days. There were no significant differences between treatment groups for pain, swelling or limitation of function.

Adverse effects

Trial withdrawals were reported in full. Of all patients receiving nabumetone, two withdrew due to lack of efficacy, and one because of nausea and vomiting. From the comparison groups, there was one drug-related withdrawal. This was from the naproxen group due to lack of efficacy.

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