Loading [MathJax]/jax/output/HTML-CSS/fonts/TeX/fontdata.js

Journal List > J Korean Soc Spine Surg > v.12(3) > 1035664

Lee, Moon, Park, Kim, Park, and Joo: A Multicenter, Double-blind, Randomized and Comparative Clinical Study for the Safety and Analgesic Effect after four-week-treatment with Neurotropin in Patients with Low Back Pain: Compared to Aceclofenac

Abstract

Study Design

A Multicenter doubleblind randomized clinical study comparing Neurotropin and A ceclofenac.

Objective

To evaluate the analgesic effect, efficacy and safety of Neurotropin in patients with low back pain.

Summary of Literature Review

Non steroidal anti inflammatory analgesics are used as the main medical treatment in patients with low back pain. However, complications, such as gastrointestinal or cardiovascular problems, have been well documented. Neurotropin acts to recover the analgesic state arising from a decrease in pain threshold and has a completely different mechanism to that of existing anti-inflammatory and narcotic analgesics, with its action of restoring the immune system having been confirmed.

Materials & Method

376 patients with back pain were randomly divided into two groups; one group was administered Neurotropin and the other A ceclofenac. The overall improvement after 4 weeks was used as the first efficacy variable, and with the second efficacy variable the improvements in spontaneous pain, tenderness, motion pain, radiating pain, severity, pain intensity, and the overall severity and Oswestry Disability Indices were used as the evaluation criteria. To evaluate safety, the abnormal clinical response and alternations on physical examination and the clinical laboratory values were used.

Results

A total of 358 patients received the experimental and comparison drugs, of which 351 were evaluated for safety. The overall improvement after 4 weeks, severity of symptoms, overall severity, and the pain intensity and Oswestry Disability Indices were decreased in both groups, but the differences between the two groups were not statistically significant. The overall decrease in the severity was greater in the Aceclofenac group, but both groups had statistically meaningful decreases after the administration of the drugs. i.e. Adverse drug reactions were less in the Neurotropin group, but these showed no significant statistical difference.

Conclusions

Neurotropin and A ceclofenac are equally effective in patients with low back pain, but in terms of safety from a clinical view point Neurotropin is more reliable.

Go to : Goto

REFERENCES

1). Wipf JE, Deyo RA. Low back pain. Med Clin North Am. 1995; 79:231–246.
crossref
2). Borenstein DG. Chronic low back pain. Rheuma Dis Clin North Am. 1996; 22:439–456.
crossref
3). Watson DJ, Harper SE, Zhao PL, et al. Gastrointestinal tolerability of the selective cyclooxygenase-2 (COX-2) inhibitor rofecoxib compared with non-selective COX-a and COX-2 inhibitors in osteoarthritis. Arch Intern Med. 2000; 160:2998–3003.
4). Hickey RF. Chronic low back pain: a comparison of diflunisal with paracetamol. New Zeal Med J. 1982; 95:312–314.
5). Portenoy RK. Current pharmacotherapy of chronic pain. J Pain Symptom Manage. 2000; 19:S16–S20.
crossref
6). Katz N, Ju WD, Krupa DA, et al. Efficacy and safety of rofecoxib in patients with chronic low back pain: results from two 4-week, randomized, placebo-controlled, paral -lel-group, double-blind trials. Spine. 2003; 28:851–858.
7). Chrubasik S, Model A, Black A, Pollak S. A randomized double-blind pilot study comparing Doloteffin and Vioxx in the treatment of low back pain. Rheumatology. 2003; 42:141–148.
8). Miura T, Okazaki R, Yoshida H, Namba H, Okai H, Kawamura M. Mechanisms of analgesic action of Neur otropinⓇon chronic pain in adjuvant-induced arthritic rat: roles of descending noradrenergic and serotonergic systems. J Pharmacol Sci. 2005; 97:429–436.
9). Sobue I, Tashiro K, Hanakago R, et al. Clinical evaluation of NeurotropinⓇinjection on dysesthesia of SMON (subacute myelo-optico-neuropathy)-a multi-institutional double-blind comparative study-. J Clin Ther Med. 1992; 8:833–851.
10). Ning G, Zou DJ, Liu W, et al. Multicenter, randomized, positive-controlled clinical study for the effects of NeurotropinⓇon diabetic neuropathy. Zhonghua Yi Xue Za Zhi. 2004; 84:1785–1787.
Go to : Goto

jkss-12-214f1.tif
Fig. 1.
Disposition of Patients
undefined
jkss-12-214f2.tif
Fig. 2.
Efficacy Evaluation (Symptom Severity Grade)
undefined
Table 1.
Demographic/Baseline Data
    Neurotropin n (%) Aceclofenac n (%) Sum n (%) p-value
Sex Male 40 (22.73) 42 (24.00) 82 (23.36) 0.7781
Female 136 (77.27)0 133 (76.00)0 269 (76.64)0  
Age (yrs) 20 ~ 39 25 (14.20) 30 (17.14) 55 (15.67)  
40 ~ 49 36 (20.45) 41 (23.43) 77 (21.94) 0.8291
50 ~ 59 70 (39.77) 65 (37.14) 135 (38.46)0  
60 ~ 69 37 (21.02) 32 (18.29) 69 (19.66)  
70 ~ 89 8 (4.55) 7 (4.00) 15 (4.27)0  
Average 52.32± 11.73 51.56± 11.18 51.94± 11.45 0.5356
Diagnosis Low Back Pain 123 (69.89)0 114 (65.14)0 237 (67.52)0 0.6305
Combined Symptom 7 (03.98) 8 (04.57) 15 (04.27)  
Other 25 (14.20) 23 (13.14) 48 (13.68)  
Prevalence period (mons) Average 90.60± 104.98 77.13± 75.17 83.79± 91.24 0.1767
Other History Yes 86 (48.86) 77 (44.00) 163 (46.44)0 0.3610
No 90 (51.14) 98 (56.00) 188 (53.56)z  
Musculoskeletal/Collagen Related 26 (30.23) 32 (41.56) 58 (35.58)  
Gasfrointestonal 16 (18.60) 11 (14.29) 27 (16.56)  
Endocrine 18 (20.93) 10 (12.99) 28 (17.18)  
Cardiovascular 38 (44.19) 28 (36.36) 66 (40.49)  
Other 42 (48.84) 30 (38.96) 72 (44.17)  
Treatment Yes 28 (15.91) 20 (11.43) 48 (13.68) 0.2219
History No 148 (84.09)0 155 (88.57)0 303 (86.32)0  

± : Mean± SD

Table 2.
Efficacy Evaluation (CGI Response Rate)-PP
  Neurotropin n (%) Aceclofenac n (%) Sum n (%) p-value
Response 90 (61.22) 94 (66.20) 184 (63.67) 0.3796
95% CI (53.35, 69.10) (58.42, 73.98) (58.12, 69.21)  
Non-response 57 (38.78) 48 (33.80) 105 (36.33)  
Sum 147 (50.87)0 142 (49.13)0 289 (100.00)  
Neurotropin - Aceclofenac One tailed 95% CI lower limit Non-inferiority limit  
(-4.97) (-14.26)   -20  
Table 3.
Efficacy Evaluation (CGI Response Rate)-PP
  Neurotropin n (%) Aceclofenac n (%) Sum n (%) p-value
Response 102 (58.96) 111 (65.68) 213 (62.28) 0.1998
95% CI (51.63, 66.29) (58.52, 72.84) (57.14, 67.42)  
Non-response 71 (41.04) 58 (34.32) 129 (37.72)  
Sum 173 (50.58) 169 (49.42) 342 (100.00)  
Neurotropin - Aceclofenac One tailed 95% CI lower limit Non-inferiority limit  
(-6.72) (-15.32) -20  
Table 4.
Efficacy Evaluation ((Pain Intensity evaluated by VAS)-PP
Pain Intensity Neurotropin Aceclofenac Sum p-value
Visit 1 n 147 142 289  
  mean± std (mm) 59.14± 17.03 57.66± 16.37 58.41± 16.70 0.4541
V2-V1 n 147 142 289  
  mean± std (mm) -10.93± 14.79 -14.74± 15.92 -12.80± 15.45 0.9087
  p-value <0.0001 <0.0001 <0.0001  
V3-V1 n 147 142 289  
  mean± std (mm) -20.97± 19.85 -24.58± 18.77 -22.74± 19.38 0.1127
  p-value <0.0001 <0.0001 <0.0001  
Table 5.
Efficacy Evaluation (Overall Severity & Oswestry Scale)-PP
Overall Severity Neurotropin Aceclofenac Sum p-value
Visit 1 n 147 142 289  
  mean± std (mm) 57.59± 15.09 58.28± 15.99 57.93± 15.52 0.7062
V2-V1 n 147 142 289  
  mean± std (mm) -9.68± 12.24 -14.88± 16.64 -12.24± 14.78 0.8693
  p-value <0.0001 <0.0001 <0.0001  
V3-V1 n 147 142 289  
  mean± std (mm) -19.56± 17.72 -24.95± 18.21 -22.21± 18.13 0.0112
  p-value <0.0001 <0.0001 <0.0001  
Oswestry Scale Neurotropin Aceclofenac Sum p-value
Visit 1 n 147 142 289  
  mean± std (%) 30.54± 13.17 31.63± 13.28 31.08± 13.21 0.4811
V2-V1 n 147 142 289  
  mean± std (%) -4.97± 9.04 -7.98± 8.81 -6.45± 9.04 0.5317
  p-value <0.0001 <0.0001 <0.0001  
V3-V1 n 147 142 289  
  mean± std (%) -6.73± 11.82 -12.38± 10.15 -9.51± 11.37 <0.0001
  p-value <0.0001 <0.0001 <0.0001  
Table 6.
Safety Evaluation
    Neurotropin n (%) Aceclofenac n (%) Sum n (%) p-value
Abnormal Manifestation rate 39 (22.16) 49 (28.00) 88 (25.07) 0.2068
Response Number of Manifestation 65 79 144  
Abnormal Manifestation rate 20 (11.36) 32 (18.29) 52 (14.81) 0.0680
Pharmacologic Number of Manifestation 31 43 74  
Response Number of Respontants 176 (50.14)0 175 (49.86)0 351 (100.00)  
TOOLS
Similar articles