Safety of ketoprofen compared with ibuprofen and diclofenac: A systematic review and meta-analysis

Piercarlo Sarzi-Puttini, Fabiola Atzeni, Luigi Lanata, Colin Gerard Egan, Michela Bagnasco

Research output: Contribution to journalArticlepeer-review


Although several randomized controlled trials have examined the efficacy of different NSAIDs in head-tohead or placebo controlled design, few studies have specifically compared the safety and tolerability of the most commonly used NSAIDSs ketoprofen, ibuprofen and diclofenac. The main objective of this meta-analysis was to compare the safety of orally administered ketoprofen compared to ibuprofen and/or diclofenac. Studies including randomized controlled trials (RCTs) comparing the safety/tolerability of oral ketoprofen (100-200 mg/day) compared to ibuprofen (800-2400 mg/day) or diclofenac (75-100 mg/day) published on computerized databases (PubMed/Medline, Cochrane Central and Embase) were considered. A total of 10 RCTs involving 826 patients met the inclusion criteria: 3 comparing ketoprofen to diclofenac and 7 comparing ketoprofen to ibuprofen. Findings from this meta-analysis did not reveal any difference in safety for ketoprofen compared to ibuprofen and/or diclofenac. The difference between ketoprofen and the pooled ibuprofen/diclofenac data was not statistically significant (risk ratio; RR=1.02, 95% CI 0.78-1.233; P=0.92) at all pointestimates of the mean weighted size effect. Further sub-analyses also confirmed that ketoprofen was not significantly different to either diclofenac (RR= 0.86; 95% CI 0.51-1.45; P=0.58) or ibuprofen (RR= 1.08; 95% CI 0.79-1.48; P=0.65) at all point-estimates. Heterogeneity for the safety measures analyzed was not statistically significant for all meta-analyses. Findings from this meta-analysis demonstrate that the safety and tolerability of orally administered ketoprofen in patients treated for moderate-severe pain is similar to that of ibuprofen and/or diclofenac.

Original languageEnglish
Pages (from-to)17-26
Number of pages10
JournalTrends in Medicine
Issue number2
Publication statusPublished - Jul 1 2014


  • Diclofenac
  • Ibuprofen
  • Ketoprofen
  • Meta-analysis
  • Non-steroidal anti-inflammatory drugs
  • Safety

ASJC Scopus subject areas

  • Internal Medicine
  • Pharmacology (medical)


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