A Randomized Controlled Trial Evaluating the Effects of Diosmin in the Treatment of Radicular Pain

Abstract

Diosmin has been widely used to treat patients with vascular pain for its potent anti-inflammatory and analgesic effects. To evaluate the therapeutic effects of Diosmin in the treatment of radicular pain, we conducted an investigator-initiated, randomized, active-controlled noninferiority trial between January 1, 2009, and December 1, 2010. Diosmin (50 mg/kg/day) was orally administered to treat the radicular pain in 150 patients for one month. Another 150 patients with the same symptom were given 20% 250 ml mannitol (1 g/kg/day) for 7 days and dexamethasone (10 mg/day) for 3 days intravenously guttae. Short-term relief and long-term relief were measured. Secondary outcomes include improvement in functional and psychological status, return to work, and reduction in anti-inflammatory analgesic drugs intake. Patients treated with oral Diosmin achieved reduction in radicular pain. The total satisfaction rate of Diosmin group was 84.7% [95% confidence interval (CI): 77.9%, 90.0%], and the complete satisfaction rate was 50.7% (95% CI: 42.4%, 58.9%). No statistically significant difference was found between the Diosmin group and the active-control group regarding patient satisfaction. No adverse effects were found during the study period. Our study suggests that clinical application of Diosmin with a dose of 50 mg/kg/day might reduce the radicular pain. This trial is registered with ISRCTN97157037.

An update on animal models of intervertebral disc degeneration and low back pain: Exploring the potential of artificial intelligence to improve research analysis and development of prospective therapeutics

“… 339 , 340 Diosmin is a citrus flavonoid (diosmetin 7‐O‐rutinoside) non‐prescription dietary supplement that has been trialed for the treatment of LBP. 294 Diosmin is reported to reduce chronic constriction injury‐induced neuropathic pain in mice 292 and provides central and peripheral anti‐hyperalgesic effects in a neuropathic pain model in rats. 293 The related flavonoid hesperidin has anti‐hyperalgesic properties in a neuropathic pain model in rats.…”

“…Lycorine reduces proinflammatory cytokine production and protects cartilage from degradation by MMPs in a mouse model of OA 339,340 . Diosmin is a citrus flavonoid (diosmetin 7‐O‐rutinoside) non‐prescription dietary supplement that has been trialed for the treatment of LBP 294 . Diosmin is reported to reduce chronic constriction injury‐induced neuropathic pain in mice 292 and provides central and peripheral anti‐hyperalgesic effects in a neuropathic pain model in rats 293 .…”

The Role of Systemic Steroids in Sciatica Due to Herniated Lumbar Disc

“…intramuscular (three trials) 22,23,25 or by intravenous injection (four trials). 26,27,30,31 The most common corticosteroid drugs used were dexamethasone (six trials [23][24][25][26]30,31 ) methylprednisolone (two trials, 22,27 ) and prednisolone (one trial 29 ) Corticosteroid dosages standardized for dexamethasone potency equivalence ranged from 8 mg to 156 mg. The rate of completers was generally high (76.2%-100%), except for one study that showed a compliance rate between 55.2% and 69.0% (Table 1).…”

“…Seven entries from four studies 22,[29][30][31] were pooled in the meta-analysis for pain intensity, showing a significant superior reduction of pain following corticosteroid treatment (SMD = −0.42, 95% CI −0.76 to −0.08, weak effect, very-low certainty). When subgrouping by the duration of follow-up, a significant reduction of pain was only seen at immediate (SMD = −0.87, 95% CI −1.46 to −0.27, large effect) and short-term follow-up (SMD = −0.97, 95% CI −1.24 to −0.73, large effect).…”

“…Six entries from three studies [29][30][31] were pooled in the meta-analysis for functional/disability scores, showing a significant reduction in disability after steroid treatment (SMD = −0.30, 95% CI −0.51 to −0.10, weak effect, verylow certainty). When subgrouping by duration of followup, reduction of disability was only significant in the long term (SMD = −0.43, 95% CI −0.71 to −0.14, weak effect).…”