Rheum Round-up: Voltaren Arthritis Pain Approved for OTC Use, Injuries That Signify Child Abuse, and more

Here are the top stories recently covered by DocWire News in the Rheumatology section. In this edition, read about the approval of Voltaren Arthritis Pain (diclofenac sodium topical gel, 1%) for nonprescription use, the pediatric injury that may signify child abuse, and the outcomes of accelerated hip fracture surgery.

The Food and Drug Administration (FDA) approved Voltaren Arthritis Pain (diclofenac sodium topical gel, 1%) for nonprescription, over-the-counter (OTC) use to treat osteoarthritis (OA)-associated pain. The medication was initially available through prescription; the change is possible through the FDA’s prescription (Rx)-to-OTC switch process. Voltaren Arthritis Pain, formerly known as Voltaren Gel 1%, received initial FDA approval in 2007. It is not intended for immediate relief; patients should allow up to seven days to feel its effects. If patients feel no change after seven days or are still using the product after 21 days, it is recommended that they terminate use and seek medical attention.

A new study discovered a correlation between children with fingertip injuries and abuse. A total of 4,870,299 presented during the study period, of whom 79,108 (1.62%) had fingertip injuries. Among the patients with fingertip injuries, 0.27% (n=216) presented, with an International Classification of Diseases, Ninth Revision diagnosis code for child abuse at that visit or in a different visit; the rate of presenting with a child abuse code among the non-fingertip injury patients was 0.22% (n=10,483). An adjusted analysis revealed that the likelihood of sustaining a fingertip injury in children who had been abused, compared to those who had not, was 23% higher (odds ratio [OR]=1.23; 95% confidence interval [CI], 1.07–1.41). Fingertip injuries were also more likely to occur in children who ever had Medicaid insurance (OR=1.40; 95% CI, 1.37–1.42) or had a behavioral risk factor (OR=1.35; 95% CI, 1.30–1.40).

A new study compared outcomes associated with accelerated hip fracture surgery versus standard care. Screening took place between March 14, 2014, and May 24, 2019. Of 27,701 patients considered for inclusion, 7,780 were eligible, and 2,970 were randomized: 1,487 to the accelerated surgery group and 1,483 to the standard care group. In the accelerated surgery group, the median time from hip fracture diagnosis to surgery was 6 hours (interquartile range [IRQ]=4–9 hours), compared to 24 hours (IQR=10–42 hours) for standard care patients (P<0.0001). Mortality rates did not largely differ between accelerated surgery and standard care patients (n=140 [9%] vs. n=154 [10%]), for a hazard ratio (HR) of 0.91 (95% confidence interval [CI], 0.72–1.14) and absolute risk reduction (ARR) of 1% (95% CI, –1 to 3; P=0.40). A total of 321 patients (22%) in the accelerated surgery group and 331 patients (22%) in the standard care group sustained major complications (HR=0.97; 95% CI, 0.83–1.13) (ARR=1%; 95% CI, –2 to 4; P=0.71).