Owen D. Williamson, MD
Is topical nitroglycerin effective for treating tendinopathies?
Included studies compared topical nitroglycerin with placebo, another intervention, or usual care in adults with acute, subacute, or chronic tendinopathy. Primary outcome was pain during activities of daily living.
ScienceDirect, Scirus, Highwire Press Stanford University, PubMed Central, Directory of Open Access Journals, Free Medical Journals, Free Full Text, Bioline International, Findarticles, BioMed Central, IndMed, OpenMD, QMed, Geneva Foundation for Medical Education and Research, Scientific Electronic Library Online, eMedicine/Medscape/MEDLINE, Biomedical E-journals, Current Contents Connect, Cochrane Library, Turning Research Into Practice, Ovid, and EBSCO, and J Med Internet Res were searched to March 2009 for randomized controlled trials (RCTs) or clinical controlled trials. 7 RCTs (n = 446, age range 18 to 79 y) met the selection criteria; all were judged to be high-quality (mean score 23.71 out of 28).
Meta-analysis showed that topical nitroglycerin was more effective than placebo for reducing pain during activities of daily living in all patients and in patients with chronic tendinopathies (Table). Risk for headache was higher in patients who received topical nitroglycerin than in those who received placebo; groups did not differ for contact dermatitis (Table).
In patients with chronic tendinopathies, topical nitroglycerin reduces pain during activities of daily living.
Topical nitroglycerin (NTG) vs placebo for treatment of tendinopathy*
*ADL = activities of daily living; other abbreviations defined in Glossary. RRR, RRI, NNT, NNH, and CI calculated from data in article (with 1 corrected data point) using a fixed-effect model.
Williamson OD. Review: Topical nitroglycerin reduces pain during ADL in patients with chronic tendinopathies. Ann Intern Med. ;154:JC2–6. doi: 10.7326/0003-4819-154-4-201102150-02006
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Published: Ann Intern Med. 2011;154(4):JC2-6.
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