As per the outcomes of a randomized controlled trial, transdermal microneedle patch (TDM) plus Ketorolac can be used for noninvasive treatment in knee osteoarthritis. The study sought to compare the effect of TDM in conjunction with nonsteroidal anti-inflammatory drug (NSAID) in joint disease. Led by Saradej Khuangsirikul and other investigators, this double-blind study involved 100 participants aged 40 to 70 years with painful knee osteoarthritis and radiographic nonstructural changes.

Volunteers were randomly assigned to get either the TDM + NSAID (Ketorolac 30 mg) or a placebo TDM, applied at the medial joint line of the knee twice weekly. The mean age of the enrolled subjects in the TDM + NSAID group was 67.4 ± 7.4 years (40 women and 10 men)  while it was 63.9 ± 8.4 years (35 women and 15 men) in the placebo group. Synovial thickness was assessed via ultrasonography prior to treatment initiation and at weeks 1, 2, and 4.

Additionally, pain levels were examined utilizing the visual analog scale (VAS), while the Western Ontario and McMaster Universities Arthritis Index (WOMAC) score and any adverse events were also documented. Compared to the placebo group, the group receiving TDM + NSAID demonstrated a noteworthy drop in synovial thickness and VAS scores at the 2nd and 4th weeks. The WOMAC score substantially improved in the 4th week in the TDM + NSAID group, as shown in Table 1:

By week 4, the mean reduction in synovial thickness measured 1.1 mm for the TDM + NSAID group and 0.3 mm for the placebo group, while the mean reduction in VAS scores was 3.2 and 1.7, respectively. Additionally, the mean WOMAC scores at week 4 illustrated significant decreases, with scores of 5.7 and 0.9 recorded for the TDM + NSAID and placebo groups, respectively.

Importantly, no complications or treatment-related adverse events were reported throughout the trial, underscoring the safety profile of the TDM plus NSAID combination. Thus, TDM + Ketorolac improved pain, satisfactory score, and inflammation in patients with early knee osteoarthritis.  These findings mark a critical advancement in the management of osteoarthritis of the knee, offering a promising therapeutic option for individuals seeking relief from joint pain.