A Review of Aceclofenac: Analgesic and Anti-Inflammatory Effects on Musculoskeletal Disorders

Abstract

Aceclofenac is an oral non-steroidal anti-inflammatory drug (NSAID) with anti-inflammatory and analgesic properties. Although there are some differences in the authorized indications between countries, aceclofenac is mainly recommended for the treatment of inflammatory and painful processes, such as low back pain (LBP), scapulohumeral periarthritis, extraarticular rheumatism, odontalgia, and osteoarthritis (OA), rheumatoid arthritis (RA), and ankylosing spondylitis (AS). The analgesic properties and tolerability profile of aceclofenac in musculoskeletal disorders are reviewed, focusing on relevant and recent studies. The efficacy and safety comparison of aceclofenac with other analgesics and anti-inflammatory agents in OA, AS, RA, and LBP is described. Relevant studies were identified following a literature search of PubMed using the terms "aceclofenac" and "clinical trials" published from 1 Jan 1992 to 1 Jan 2020. Aceclofenac is at least as effective as other NSAIDs in reducing pain and/or improving functional capacity in chronic pain conditions (OA, AS, RA, and LBP). It is generally well tolerated and appears to have a more favorable GI profile than other NSAIDs. Thus, current evidence indicates that aceclofenac is a useful option for the management of pain and inflammation across a wide range of painful conditions.

Keywords: NSAIDs; aceclofenac; analgesia; low back pain; osteoarthritis.

Figure 1

Tolerability of aceclofenac versus naproxen (A and B), piroxicam (C), indomethacin (D) and ketoprofen (E) in clinical studies. p values reported where available.

Figure 2

The pooled relative risk (RR) of upper gastrointestinal complications with the use of NSAIDs versus non-use of NSAIDs according to a systematic review and meta-analysis of observational studies. Vertical bars represent 95% confidence intervals. Of note, rofecoxib has been withdrawn from the market due to cardiovascular adverse events. Republished from Springer Nature, Castellsague J, Riera-Guardia N, Calingaert B, et al. Individual NSAIDs and upper gastrointestinal complications: a systematic review and meta-analysis of observational studies (the SOS project). Drug Saf. 2012;35(12):1127–1146; permission conveyed through Copyright Clearance Center, Inc.