Ergebnisse einer Doppelblindprüfung Diclofenac+Vitamin B1, B6, B12 versus Diclofenac bei Patienten mit akuten Beschwerden im Lendenwirbelsäulenbereich

Brüggemann, G.; Koehler, Christina; Koch, Ernst

doi:10.1007/bf01646858

Cited by 46 publications

(10 citation statements)

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“…Die [7,8,40,41,58], oder die Schmerzen mit einer niedrigeren täglichen Dosis von Diclofenac als normalerweise üblich behandelt werden konnten [40,42].…”

Section: Kombinationen Von B-vitaminen Mit Analgetikaunclassified

Analgetische und analgesiepotenzierende Wirkung von B-Vitaminen

Jurna

1998

Der Schmerz

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Disregarding pain resulting from vitamin deficiency, an analgesic effect seems to be exerted only by vitamin B1 (thiamine), vitamin B6 (pyridoxines), and vitamin B12 (cobalamine), particularly when the three are given in combination. The analgesic effect is attributed to an increased availability and/or effectiveness of noradrenaline and 5-hydroxytryptamine acting as inhibitory transmitters in the nociceptive system. In animal experiments, high doses of these vitamins administered alone or in combination inhibited nociceptive behavior and depressed the nociceptive activity evoked in single neurons of the dorsal horn of the spinal cord and in the thalamus. Moreover, they were found to enhance the antinociceptive effect of non-opioid analgesic agents on withdrawal reflexes. Clinical data fail in most cases to meet current standards of evaluation (randomization, double-blindness). Still, it appears that high doses of the vitamins B1, B6, and B12 administered separately or in combination can alleviate acute pain and potentiate the analgesia caused by non-opioid analgesics such as the NSAIDs and metamizol (dipyrone). Therapeutic effects are observed in neuropathic pain and pain of musculoskeletal origin. Vitamin B6 is effective in the carpal tunnel syndrome which, however, is attributed at least in some cases to vitamin B6 deficiency. It is also worth noting that the B vitamins are shown to enhance the beneficial effect of diclofenac in acute low-back pain so that either the duration of treatment or the daily dose of diclofenac may be reduced. The use of high doses of vitamin B6 may be limited by a neurotoxic effect. The effectiveness of B vitamins in depressing chronic pain has not been established. It would be interesting to know if the B vitamins are of use as adjuvants in the treatment of tumor pain.

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“…Die [7,8,40,41,58], oder die Schmerzen mit einer niedrigeren täglichen Dosis von Diclofenac als normalerweise üblich behandelt werden konnten [40,42].…”

Section: Kombinationen Von B-vitaminen Mit Analgetikaunclassified

Analgetische und analgesiepotenzierende Wirkung von B-Vitaminen

Jurna

1998

Der Schmerz

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“…The combination of diclofenac with vitamins B 1 , B 6 , and B 12 has been reported to be beneficial in the treatment of painful conditions, including post-operative pain [9], osteoarthritis [10], and especially low back pain. Prior to the publication of the DOLOR trial, encouraging results in clinical studies of low back pain employing the combination of vitamins B 1 , B 6 , and B 12 with diclofenac had been reported in the literature, especially in terms of shortened treatment time to satisfactory analgesia when compared with diclofenac monotherapy [11]- [14]. The results of the DOLOR study confirmed these findings and the results of this post-hoc analysis reinforced the benefit of adding vitamins B 1 , B 6 , and B 12 to diclofenac therapy in terms of shorter treatment time to desired clinical effect.…”

Section: Discussionmentioning

confidence: 99%

Impact of Low Back Pain on Quality of Life: Assessment by Patient Functionality Questionnaire and Treatment Results Using a Combination of Diclofenac plus B Vitamins or Diclofenac Monotherapy

Geller¹,

Mibielli²,

Nunes³

et al. 2016

IJCM

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Objective: To analyze the Patient Functionality Questionnaire (PFQ) scores of the patients treated with either Diclofenac + B vitamins (Group DB) or Diclofenac monotherapy (Group D) in order to better understand the impact of the combination of diclofenac with vitamins B1, B6, and B12 on quality of life. Research Design/Methods: We performed a post-hoc analysis of tabulated data generated during the DOLOR study (Diclofenac plus B vitamins versus diclofenac monotherapy in lumbago: the DOLOR study), using the software GraphPad Prism 5 for Windows, v5.04. The absolute number or percentage of "True"/"False" respondents for each questionnaire item at each study visit, together with the absolute number and percentage of subjects with no change, improvement, or worsening of each PFQ item at each study visit, within and between treatment groups were arranged on contingency tables and analyzed with the Chi-squared or Fisher's Exact test. Results: At pretreatment there were no statistically significant differences between treatment groups (p > 0.05 for all items). At Visit 2 in both treatment groups, there were statistically significant improvements in individual question responses in each of the 12 items of the questionnaire (p < 0.05 for all items). At Visit 2, comparing the distribution of patients in each treatment group with "improvement", "no change", or "worsening", there was a statistically significant superiority among subjects of group DB in response to items 1, 6, 8, and 10. At Visit 3, both groups had statistically significant (p < 0.001) improvements in each individual item of the PFQ in relation to pre-* Corresponding author. M. Geller et al. 114 treatment values. The distribution of subjects in each treatment group presenting with "improvement", "no change", or "worsening" at Visit 3 varied significantly in favor of group DB in the responses to item 4. At Visit 4, the subjects remaining in treatment in both groups showed statistically significant improvement in PFQ responses in relation to pretreatment values (p < 0.05). The distribution of subjects in each treatment group presenting with "improvement" or "no change" at Visit 4 varied significantly in favor of group D in the responses to items 5, 8, and 12. Conclusion: Improvement in overall PFQ scores was observed in both treatment groups, though the specific items of the questionnaire of the subjects in group DB at Visit 2 showed greater improvement in areas related to sleep quality, mobility, ability to wash and dry, ability to walk distances, and posture comfort. These results serve to corroborate the previously published data, which indicates a benefit of combining the B vitamins with diclofenac in the treatment of patients with low back pain, yielding shorter treatment time to resolution of the lumbago in the treated patients.

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“…The methodological aspect is highlighted by a report [16,17] that the consumption of 100 g fat after a 12 hours fasting period causes a significant decrease (!!) in platelet aggregability upon both, ADP and collagen.…”

Section: Discussionmentioning

confidence: 99%

Platelet function in the postprandial period

Sinzinger

Berent²

2012

Thrombosis J

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BackgroundPostprandial hyperlipidemia and hyperglycemia have been related to cardiovascular events. Among different underlying mechanisms platelet activation seems to be responsible too. No comparable data between various tests in normo- vs. hyperlipidemics before and at different time intervals are available after a fat meal. We aimed to compare 9 of them within the same patients at several time points in postprandial hyperlipidemia.ResultsFor some tests baseline values between the groups were significantly different (TXB2, platelet sensitivity, sedimentation and WU-test). However, hyperlipidemia revealed a variable influence on the tests examined. Some of the available tests apparently sensitive to show platelet activation reflect the increase in triglycerides (TG), such as the sedimentation index. ADP-induced platelet aggregatory activity in count adjusted washed isolated platelet samples during postprandial hyperlipidemia indicates mildly enhanced platelet activity, but does not seem to induce significant changes in aggregation. In patients with severe hypertriglyceridemia (> 400 mg/dl fasting) changes in platelet function are more pronounced due to delayed decay and may last up to 16 hours paralleling TG reaching the prevalue. The overwhelming majority of platelet function tests do not significantly respond to postprandial hyperlipidemia. The correlation between the tests applied is poor. For standardization purpose, platelet aggregation tests, aimed to examine proaggregatory capacity in atherosclerosis, should only be performed at the same time of the day after a fasting period > 6 hours. The great variation in preanalytical work-up on comparison of various tests, large number of platelet tests available and their respective potential value are discussed.ConclusionsAt present, the suspicion that platelet function is significantly activated in the postprandial period cannot be supported by any of the tests used. The information provided is valuable to know for which test and group of patients a fasting period of which duration is recommendable.

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Ergebnisse einer Doppelblindprüfung Diclofenac+Vitamin B1, B6, B12 versus Diclofenac bei Patienten mit akuten Beschwerden im Lendenwirbelsäulenbereich

Cited by 46 publications

References 2 publications

Analgetische und analgesiepotenzierende Wirkung von B-Vitaminen

Analgetische und analgesiepotenzierende Wirkung von B-Vitaminen

Impact of Low Back Pain on Quality of Life: Assessment by Patient Functionality Questionnaire and Treatment Results Using a Combination of Diclofenac plus B Vitamins or Diclofenac Monotherapy

Platelet function in the postprandial period

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