Efficacy of transdermal ketoprofen for delayed onset muscle soreness

Objective: To determine the efficacy of transdermal ketoprofen in reducing delayed-onset muscle soreness (DOMS), limiting systemic absorption, and improving postexercise function following repetitive muscle contraction. Design: Double-blind, placebo-controlled clinical trial. Setting: OrthoMed, University of California at San Diego, La Jolla, CA, U.S.A. Participants: Thirty-two healthy mates 18 to 35 years old. Interventions: Subjects performed a leg extension and flexion exercise program designed to create DOMS in quadriceps muscles. Subjects were randomly assigned to receive any combination of transdermal ketoprofen or placebo cream, applied TID, to their right and left quadriceps. Main Outcome Measures: Subjective measure of DOMS in quadriceps muscles, serum ketoprofen levels, strength index scores (a measure of postexercise function), and adverse reactions were assessed at baseline, 24 hours, and 48 hours. Results: Within-subjects analysis (n = 16) showed a significant reduction in DOMS scores in legs receiving transdermal ketoprofen compared with legs receiving placebo cream (P = 0.002 at 48 hours and 0.000 at 24 and 48 hours combined). Between-subjects analysis (n = 16) showed a marginally significant reduction in DOMS scores at 48 hours (P = 0.05 in right legs and 0.053 in left legs). Systemic absorption was minimal, with serum ketoprofen levels in the ng/mL range. No differences in strength index scores were observed. No adverse reactions were reported. Conclusions: Transdermal ketoprofen appears to be effective in reducing self-reported DOMS after repetitive muscle contraction, particularly after 48 hours. Systemic absorption of the drug was minimal. Treatment did not appear to have any effect on postexercise function, and there were no reported adverse reactions.