Analgesic Effect of Topical Piroxicam vs Phytotherapy Gel in the Treatment of Acute Soft Tissue Injuries: A Randomized Controlled Noninferiority Study

Pain Med. 2023 Jun 1;24(6):586-592. doi: 10.1093/pm/pnac176.

Abstract

Objective: The study compared the efficacy and tolerability of piroxicam gel and a new topical combination of medicinal plant products (Soulagel®; Belpharma Tunisia) to treat pain caused by soft tissue injuries.

Methods: Patients (n = 1,525) were assigned to receive piroxicam gel or Soulagel. Efficacy assessments included a change of at least 50% in the pain-on-movement visual numeric scale rating from emergency department discharge (baseline) to day 7 final assessment, as well as the time required to reach pain resolution criteria, the need for rescue analgesia, patients' satisfaction, and the rate of adverse effects.

Results: At day 7, 1,216 patients (79.7%) achieved at least 50% reduction in visual numeric scale rating from baseline: 623 patients (82.4%) in the Soulagel group vs 593 patients (77.1%) in the piroxicam group (P = 0.01). Time to decrease pain on movement by 50% was significantly higher with piroxicam gel than with Soulagel (34 ± 1 vs 33 ± 1 days, respectively; P = 0.54). At day 7, 96.4% of patients in the Soulagel group declared being "very satisfied" to "satisfied," vs 68% in the piroxicam group (P < 0.001). There were no major adverse events in either group.

Conclusions: Soulagel is not inferior to piroxicam gel for managing pain related to a soft tissue injuries. Further studies will help ascertain whether this new gel offers an alternative treatment option for this common emergency department condition.

Keywords: Acute Pain; Analgesics; Herbal Preparation; Ointment; Piroxicam; Soft Tissue Injuries; Topical Administration.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Analgesics / therapeutic use
  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects
  • Humans
  • Pain / drug therapy
  • Phytotherapy
  • Piroxicam* / adverse effects
  • Piroxicam* / therapeutic use
  • Soft Tissue Injuries* / drug therapy

Substances

  • Piroxicam
  • Analgesics
  • Anti-Inflammatory Agents, Non-Steroidal