Photobiomodulation therapy enhances topical diclofenac absorption in healthy volunteers – a randomized placebo-controlled trial: preliminary results

Authors

DOI:

https://doi.org/10.33448/rsd-v10i12.20448

Keywords:

Photobiomodulation; Tandem mass spectrometry; Bioavailability; Pharmacokinetics; Laser; Diclofenac.

Abstract

The inflammatory Muscle-skeletal disorders are responsible for a high economic impact on public health and Pharmacological treatments produce important renal and gastric toxicity especially. However, the real effects of topical NSAID’s still controversial. Photobiomodulation therapy has been used to treat musculo-skeletal conditions.  The aim of this study was to evaluate the effects of Photobiomodulation on topical absorption of sodium diclofenac in healthy volunteers. Methods. The volunteers were selected after an assessment of their state of health. The study began with 12 volunteers with dark skin and 12 white skin. The study was designed to determinate the pharmacokinetic parameters. The volunteers received during hospitalization 5g diclofenac gel in the presence or not of photobiomodulation, following the randomization. A Laser Cluster with 14 laser diodes (100 mW/diode) delivered 3 Joules of Energy/diode (spot area 0.028 Cm2). Blood samples were taken for determination of plasmatic diclofenac concentration (0.5, 1, 2, 3, 4, 5, 6, 7, 8, 10, 12, 14, 16, 18, 24h) by tandem mass spectrometry. Low Power Laser Therapy operating at a wavelength of 650 nm was effective to enhance the absorption of diclofenac emulgel in white-skinned individuals but not in black-skinned individuals. Maximum plasma concentrations were higher in the white-skinned group of volunteers who received low-power laser irradiation prior to drug application when compared to the placebo group.

References

Andres, B. M., & Murrell, G. A. (2008) Treatment of tendinopathy: what works, what does not, and what is on the horizon. Clin Orthop Relat Res. 466(7):1539-54.

Banning M. (2008) Topical diclofenac: clinical effectiveness and current uses in osteoarthritis of the knee and soft tissue injuries. Expert Opin Pharmacother. 9(16):2921-9.

Batistela, M. A., Chorilli, M., & Leonardi, G. R. (2007) Abordagens no estudo do envelhecimento cutâneo em diferentes etnias. Revista Bras. Farmácia, 88(2), 59-62.

Bjordal, J. M., Klovning, A., Ljunggren, A. E., & Slørdal, L. (2007) Short-term efficacy of pharmacotherapeutic interventions in osteoarthritic knee pain: A meta-analysis of randomised placebo-controlled trials. Eur J Pain. 11(2):125-38.

de Paiva Carvalho, R. L. Leonardo, P. S. L. M., Mendes, G. D. Lima, F. P., Lima, M. O., Marcos, R. L., & Lopes-Martins, R. A. B. (2019) Pharmacokinetic and Pharmacodynamics of Sodium Diclofenac (Topical and IM) Associated with Laser Photobiomodulation on Skeletal Muscle Strain in Rats. International Journal of Photoenergy, 1-12.

Dean, B. J., Lostis, E., Oakley, T., Rombach, I., Morrey, M. E., & Carr, A. J. (2014) The risks and benefits of glucocorticoid treatment for tendinopathy: a systematic review of the effects of local glucocorticoid on tendon. Semin Arthritis Rheum. 43(4):570-6.

Egelrud, T. (2000) Desquamation in the Stratum Corneum. Acta Derm Venereol; Supp 208: 44-45.

Gómez, C., Costela, A., García-Moreno, I., Llanes, F., Teijón, J. M., & Blanco, M. D. (2008) Laser treatments on skin enhancing and controlling transdermal delivery of 5-fluorouracil. Lasers Surg Med. 40(1):6-12.

Ivandic, B. T., & Ivandic, T. (2008) Low-level laser therapy improves vision in patients with age-related macular degeneration. Photomed Laser Surg. 26(3):241-5.

Kami, T., Yoshimura, Y., Nakajima, T., Ohshiro, T., & Fujino, T. (1985) Effects of low-power diode lasers on flap survival. Ann Plast Surg. 14(3):278-83.

Khan, K. M., Cook, J. L., Maffulli, N., & Kannus, P. (2000) Where is the pain coming from in tendinopathy? It may be biochemical, not only structural, in origin. Br J Sports Med. 34(2):81-3.

Kipshidze, N., Petersen, J. R., Vossoughi, J., Nikolaychik, V., Bakhutashvili, I., Roubin, G. S., Leon, M. B., & Moses, J. W. (2000) Low-power laser irradiation increases cyclic GMP synthesis in penile smooth muscle cells in vitro. J Clin Laser Med Surg. 18(6):291-4.

Liu, C., Zhi, Z., Tuchin, V. V., Luo, Q., & Zhu, D. (2010) Enhancement of skin optical clearing efficacy using photo-irradiation. Lasers Surg Med. 42(2), 132-40.

Maegawa,Y., Itoh, T., Hosokawa, T., Yaegashi, K., & Nishi, M. (2000) Effects of near-infrared low-level laser irradiation on microcirculation. Lasers Surg Med. 27(5), 427-37.

Marcos, R. L., Leal-Junior, E. C., Arnold, G., Magnenet, V., Rahouadj, R., Wang, X., Demeurie, F., Magdalou, J., de Carvalho, M. H., & Lopes-Martins, R. Á. (2012) Low-level laser therapy in collagenase-induced Achilles tendinitis in rats: analyses of biochemical and biomechanical aspects. J Orthop Res. 30(12):1945-51. 10.1002/jor.22156.

McCormack, P. L., & Scott, L. J. (2008) Diclofenac sodium injection (Dyloject): in postoperative pain. Drugs. 68(1):123-30. Review. Erratum in: Drugs. 2008; 68(6):801

Miot, L. D. B. (2009) Fisiopatologia Do Melasma. In: Anais Bras. Dermatologia, 84(6), 623-635.

Miro, A. M., Shivaram, U., & Finch, P. J. (1989) Noncardiogenic pulmonary edema following laser therapy of a tracheal neoplasm. Chest. 96(6):1430-1.

Miyatake, S., Ichiyama, H., Kondo, E., & Yasuda, K. (2009) Br J Clin Pharmacol. 67(1):125-9. Randomized clinical comparisons of diclofenac concentration in the soft tissues and blood plasma between topical and oral applications.

Plass, C. A., Loew, H. G., Podesser, B. K., & Prusa, A. M. (2012) Light-induced vasodilation of coronary arteries and its possible clinical implication. Ann Thorac Surg.93(4):1181-6. 10.1016/j.athoracsur.2011.12.062.

Samoilova, K. A., Zhevago, N. A., Petrishchev, N. N., & Zimin, A. A. (2008) Role of nitric oxide in the visible light-induced rapid increase of human skin microcirculation at the local and systemic levels: II. healthy volunteers. Photomed Laser Surg. 26(5):443-9.

Stanos, S. P. (2007) Topical agents for the management of musculoskeletal pain. J Pain Symptom Manage. 33(3):342-55.

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Published

19/09/2021

How to Cite

LEONARDO, P. S. .; CARVALHO, R. L. de P. .; SILVA, S. G. da .; MENDES, G. D. .; NUCCI, G. de; LOPES-MARTINS, R. A. B. Photobiomodulation therapy enhances topical diclofenac absorption in healthy volunteers – a randomized placebo-controlled trial: preliminary results. Research, Society and Development, [S. l.], v. 10, n. 12, p. e265101220448, 2021. DOI: 10.33448/rsd-v10i12.20448. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/20448. Acesso em: 22 nov. 2024.

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Section

Health Sciences