OA knee pain comorbidities

Common comorbidities that your patients with OA
knee pain may have:

Coronary heart disease2,7

Renal impairment (CKD)3







Mean number of drug classes used by newly diagnosed diabetes patients8


Median number of medications taken 5 years after diabetes diagnosis9


Percent of patients with hypertension taking multiple antihypertension medications10


Mean number of medications patients with CKD take11

Systemic exposure considerations


  • Physicians should weigh the risks of NSAIDs, including severe cardiovascular (CV) risks, when considering topical NSAIDs12
  • Even topical NSAIDs pose serious CV and gastrointestinal (GI) risks12
  • Hypertension can occur with NSAID treatment. Monitor blood pressure closely12,13
  • Long-term administration of NSAIDs can result in renal papillary necrosis, other renal injury, and renal toxicity12,13

Industry guidance

Experts recommend topical NSAIDs for patients with OA knee pain

American College of Rheumatology logo

Strongly recommends topical NSAIDs for patients with OA of the knee(s) and should be considered prior to the use of oral NSAIDs due to lower systemic exposure14

Osteoarthritis Research Society International logo

Strongly recommends topical NSAIDs as first-line medications for OA knee pain in patients with or without comorbidities1

Icon Knee PainIcon Knee PainIcon Knee Pain

What’s your treatment strategy for patients with OA knee pain?

Consider a topical for your patients.

Get the details

GI=gastrointestinal; NSAID=nonsteroidal anti-inflammatory drug; OA=osteoarthritis.

  • Bannuru RR, Osani MC, Vaysbrot EE, et al. OARSI guidelines for the non‐surgical management of knee, hip, and polyarticular osteoarthritis. Osteoarthritis Cartilage. 2019;27(11):1578‐1589.
  • Mozaffarian D, Benjamin EJ, Go AS, et al. Heart disease and stroke statistics—2015 update: a report from the American Heart Association. Circulation. 2015;131(4):e29-e322.
  • National Institute of Diabetes and Digestive and Kidney Diseases. Kidney disease statistics for the United States. National Institute of Diabetes and Digestive and Kidney Diseases website. https://www.niddk.nih.gov/health-information/health-statistics/kidney-disease. Accessed June 14, 2020.
  • Centers for Disease Control and Prevention. National diabetes statistics report 2020. Centers for Disease Control and Prevention website. https://www.cdc.gov/diabetes/pdfs/data/statistics/national-diabetes-statistics-report.pdf. Accessed June 14, 2020.
  • Nwankwo T, Yoon SS, Burt V, Gu Q. Hypertension among adults in the United States: National Health and Nutrition Examination Survey, 2011-2012. NCHS Data Brief. 2013;(133):1-8.
  • Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of obesity among adults: United States, 2011-2012. NCHS Data Brief. 2013;(131):1-8.
  • Arthritis Foundation. Arthritis by the numbers. Arthritis Foundation website. https://www.arthritis.org/getmedia/73a9f02d-7f91-4084-91c3-0ed0b11c5814/abtn-2020-final.pdf. Accessed June 14, 2020.
  • Schmittdiel JA, Raebel MA, Dyer W, et al. Prescription medication burden in patients with newly diagnosed diabetes: a SUrveillance, PREvention, and ManagEment of Diabetes Mellitus (SUPREME-DM) study. J Am Pharm Assoc (2003). 2014;54(4):374-382.
  • Black JA, Simmons RK, Boothby CE, et al. Medication burden in the first 5 years following diagnosis of type 2 diabetes: findings from the ADDITION-UK trial cohort. BMJ Open Diabetes Res Care. 2015;3(1):e000075.
  • Gu Q, Burt VL, Dillon CF, Yoon S. Trends in antihypertensive medication use and blood pressure control among United States adults with hypertension: the National Health and Nutrition Examination Survey, 2001-2010. Circulation. 2012;126(17):2105-2114.
  • Bailie GR, Eisele G, Liu L, et al. Patterns of medication use in the RRI-CKD study: focus on medications with cardiovascular effects. Nephrol Dial Transplant. 2005;20(6):1110-1115.
  • PENNSAID (diclofenac sodium topical solution) 2% [prescribing information] Horizon.
  • Crofford LJ. Use of NSAIDs in treating patients with arthritis. Arthritis Res Ther. 2013;15(suppl 3):S2.
  • Kolasinski SL, Neogi T, Hochberg MC, et al. 2019 American College of Rheumatology/Arthritis Foundation guideline for the management of osteoarthritis of the hand, hip, and knee. Arthritis Care Res (Hoboken). 2020;72(2):149-162.