A Randomized Control Trial of Dexketoprofen/Vitamin B (Thiamine, Pyridoxine and Cyanocobalamin) Fixed-Dose Combination in Post-Traumatic Grade I-II Cervical Sprains.

IF 2.9 3区 医学 Q2 PHARMACOLOGY & PHARMACY Clinical Drug Investigation Pub Date : 2024-06-01 Epub Date: 2024-06-06 DOI:10.1007/s40261-024-01370-2
Pamela Delgado-García, Juan Bautista Alcocer-Herrera, Adelfia Urenda-Quezada, María Dolores Alonso-Martinez, María Arcelia Bautista-Mendoza, Yulia Romero-Antonio, Julio C Mora-Villalobos, José G Sander-Padilla, Kevin F Rios-Brito, Ileana C Rodríguez-Vazquez, Jorge González-Canudas
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Abstract

Background: Musculoskeletal disorders are an important cause of work absence. Clinical practice guidelines recommend nonsteroidal anti-inflammatory drugs (NSAIDs) for grade I-II cervical sprains. The combination of thiamine + pyridoxine + cyanocobalamin vitamins has been used, alone and in combination with NSAIDs, for pain and inflammation in musculoskeletal disorders.

Objective: The objective of this study was to demonstrate the analgesic synergy of dexketoprofen, and the combination of vitamins thiamine + pyridoxine + cyanocobalamin in a fixed-dose combination (FDC) for the treatment of acute pain caused by grade I-II cervical sprains.

Methods: We conducted a multicentre, prospective, randomized, double-blind, phase IIIb clinical study comparing two treatment groups: (1) dexketoprofen 25 mg/vitamin B (thiamine 100 mg, pyridoxine 50 mg and cyanocobalamin 0.50 mg) in an FDC (two or more active ingredients combined in a single dosage form) versus (2) dexketoprofen 25 mg monotherapy (single drug to treat a particular disease), one capsule or tablet orally, every 8 h for 7 days. Final mean, average change, and percentage change in pain perception (measured using a visual analogue scale [VAS]) were compared with baseline between groups. A p value < 0.05 was considered statistically significant. Analyses were conducted using SPSS software, v.29.0.

Results: A statistically significant reduction in pain intensity was observed from the third day of treatment with the FDC compared with monotherapy (- 3.1 ± - 1.5 and - 2.6 ± - 1.1 cm, respectively) measured using the VAS (p = 0.011). Regarding the degree of disability, using the Northwick Park Neck Pain Questionnaire (NPQ), statistical difference was observed for the final measurement (7.5%, interquartile range [IQR] 2.5, 10.5; vs. 7.9%, IQR 5.0, 13.8; p = 0.028). A lower proportion of adverse events was reported when using the FDC.

Conclusions: The FDC of dexketoprofen/thiamine + pyridoxine + cyanocobalamin vitamins demonstrated superior efficacy and a better safety profile compared with dexketoprofen monotherapy for pain treatment in patients with grade I-II cervical sprains.

Clinical trials registration: NCT05001555, registered 29 July 2021 ( https://clinicaltrials.gov/study/NCT05001555 ).

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右酮洛芬/维生素 B(硫胺素、吡哆醇和氰钴胺素)固定剂量复方制剂治疗创伤后 I-II 级颈椎扭伤的随机对照试验。
背景:肌肉骨骼疾病是造成缺勤的一个重要原因。临床实践指南建议对 I-II 级颈椎扭伤使用非甾体抗炎药(NSAIDs)。硫胺素+吡哆醇+氰钴胺维生素组合已被单独或与非甾体抗炎药联合用于治疗肌肉骨骼疾病的疼痛和炎症:本研究旨在证明右酮洛芬与硫胺素+吡哆醇+氰钴胺维生素的固定剂量复方制剂(FDC)在治疗 I-II 级颈椎扭伤引起的急性疼痛方面的镇痛协同作用:我们进行了一项多中心、前瞻性、随机、双盲、IIIb期临床研究,比较了两个治疗组:(1) 右酮洛芬25毫克/维生素B(硫胺素100毫克、吡哆醇50毫克和氰钴胺0.50毫克)固定剂量复合制剂(两种或多种活性成分以单一剂型组合)与(2) 右酮洛芬25毫克单一疗法(治疗特定疾病的单一药物),每8小时口服一粒胶囊或片剂,连续7天。各组间疼痛感觉的最终平均值、平均变化和百分比变化(使用视觉模拟量表[VAS]测量)与基线进行比较。结果使用视觉模拟量表测量(p = 0.011),与单药治疗相比,使用 FDC 治疗的第三天起,疼痛强度明显降低(分别为 - 3.1 ± - 1.5 厘米和 - 2.6 ± - 1.1 厘米)。在残疾程度方面,使用诺斯维克帕克颈部疼痛问卷(NPQ)进行的最终测量结果存在统计学差异(7.5%,四分位数间距 [IQR] 2.5,10.5;vs. 7.9%,IQR 5.0,13.8;p = 0.028)。使用复方新诺明的不良事件报告比例较低:结论:在I-II级颈椎扭伤患者的疼痛治疗中,右酮洛芬/硫胺素+吡哆醇+氰钴胺维生素的FDC与右酮洛芬单药治疗相比,疗效更优,安全性更好:NCT05001555,2021年7月29日注册 ( https://clinicaltrials.gov/study/NCT05001555 )。
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来源期刊
CiteScore
5.90
自引率
3.10%
发文量
108
审稿时长
6-12 weeks
期刊介绍: Clinical Drug Investigation provides rapid publication of original research covering all phases of clinical drug development and therapeutic use of drugs. The Journal includes: -Clinical trials, outcomes research, clinical pharmacoeconomic studies and pharmacoepidemiology studies with a strong link to optimum prescribing practice for a drug or group of drugs. -Clinical pharmacodynamic and clinical pharmacokinetic studies with a strong link to clinical practice. -Pharmacodynamic and pharmacokinetic studies in healthy volunteers in which significant implications for clinical prescribing are discussed. -Studies focusing on the application of drug delivery technology in healthcare. -Short communications and case study reports that meet the above criteria will also be considered. Additional digital features (including animated abstracts, video abstracts, slide decks, audio slides, instructional videos, infographics, podcasts and animations) can be published with articles; these are designed to increase the visibility, readership and educational value of the journal’s content. In addition, articles published in Clinical Drug Investigation may be accompanied by plain language summaries to assist readers who have some knowledge, but non in-depth expertise in, the area to understand important medical advances.
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