【在现实世界的临床实践中优化背痛症的诊断和治疗:DORISS多中心观察性研究的次要终点】。

Y A Merkulov, A M Gamburg, D S Lezina, A N Fedorova, A A Onsin, D M Merkulova
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引用次数: 0

摘要

目的:基于DORISS观察性非介入性多中心研究结果,评价Ipigrix在腰骶棘背痛症(DA)患者综合治疗中的疗效。材料和方法:在俄罗斯联邦的200个临床中心共检查了3563例确诊为DA的患者,他们根据病分学标准接受了可比较的基线治疗,其中一些患者额外接受了口服或交错治疗Ipigrix。376例患者接受DA基线治疗(治疗组1),1026例患者联合口服Ipigrix(治疗组2),2161例患者联合交错处方ipidacrine(治疗组3)。研究的次要终点包括观察期间不同治疗的临床症状改善情况、疼痛NRS和DN4评分值及rolandmorris问卷,并评估其安全性。结果:协方差分析的结果排除了混杂因素(年龄和使用量表的初始指标)对DA结果的影响,并表明通过交错方案额外接受Ipigrix的患者疼痛减轻最大。假随机化组间比较显示,无论Ipigrix给药类型如何,联合治疗在主要椎体综合征表现、感觉和运动障碍、疼痛缓解以及神经性症状、神经生理参数改善和生活功能恢复方面均有统计学显著的益处,且无严重药物相关不良事件。结论:Ipigrix (ipidacrine)是一种安全有效的治疗DA的辅助镇痛药。
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[Optimizing the diagnosis and treatment of dorsalgia in real-world clinical practice: the secondary endpoint of the DORISS multicenter observational study].

Objective: To evaluate the efficacy of Ipigrix in the complex treatment of patients with dorsalgia (DA) of the lumbosacral spine based on the results of the DORISS observational non-interventional multicenter study.

Material and methods: Overall 3563 patients with verified diagnoses of DA at 200 clinical centers within the Russian Federation who received comparable baseline therapy according to nosological standards were examined, some of them additionally received oral or staggered treatment with Ipigrix. Baseline therapy for DA was given to 376 patients (treatment group 1), combination of baseline with oral Ipigrix was given to 1026 patients (group 2), and combination with staggered prescription of ipidacrine - to 2161 (group 3). Secondary endpoint of the study included analysis of the improvement of clinical symptoms, values of pain NRS and DN4 scales together with Roland-Morris questionnaire during the period of observation depending on the therapy with an assessment of its safety.

Results: The results of the analysis of covariance allowed to exclude the influence of confounders (age and initial indicators of the utilized scales) on DA outcomes and demonstrated the greatest pain reduction in patients who additionally received Ipigrix via the staggered scheme. The inter-group comparison aligned by pseudorandomization showed statistically significant benefits of combined therapy regardless of the type of Ipigrix administration concerning main vertebral syndrome manifestations, sensory and motor disturbances, relief of pain, as well as neuropathic symptoms, improvement of neurophysiological parameters and restoration of life functioning without serious drug related adverse events.

Conclusion: Ipigrix (ipidacrine) can be considered an effective and safe adjuvant analgesic in the treatment of DA.

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来源期刊
Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova
Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova Medicine-Psychiatry and Mental Health
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