Clin Exp Rheumatol
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Randomized Controlled Trial Comparative Study Clinical Trial
A double-blind, randomized, controlled study of amitriptyline, nortriptyline and placebo in patients with fibromyalgia. An analysis of outcome measures.
To study the efficacy and tolerability of amitriptyline and nortriptyline in a Brazilian population with fibromyalgia and to evaluate the instruments used to measure the efficacy of the treatment. ⋯ All three groups improved after treatment. Only the patient's subjective global assessment of improvement differed between the AM patients and the PL group (p < or = 0.03). In fibromyalgia, placebo groups are important in drug trials. Different measures of therapeutic effect are not better than the patient's self assessment.
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Randomized Controlled Trial Comparative Study Clinical Trial
Effects of long-term cyclic iloprost therapy in systemic sclerosis with Raynaud's phenomenon. A randomized, controlled study.
Iloprost is a stable prostacyclin analogue which has been shown to be effective in the short-term symptomatic treatment of Raynaud's phenomenon (RP) secondary to systemic sclerosis (SSc). The aim of this study was to evaluate the effects of long-term cyclic therapy with iloprost in comparison with nifedipine on the skin score, pulmonary function and Raynaud's severity score in patients with SSc and RP. ⋯ In SSc patients, cyclic intravenous iloprost infusion is able to control vasospastic disease. Our results suggest that it might also act as a disease-modifying agent, as it seems to improve the course of the disease. Further studies principally focused on organ involvement and the natural history of the disease are needed to confirm our results.
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Randomized Controlled Trial Comparative Study Clinical Trial
Corticosteroid injection for osteoarthritis of the knee: peripatellar compared to intra-articular route.
Intra-articular injection of micro-crystalline corticosteroid is used to treat symptomatic osteoarthritis (OA) of the knee, but its duration of effect and efficacy are uncertain. From the observation that pain in OA of the knee can often be blocked by infiltration of the soft tissues at the patella margin with local anaesthetic, this study investigated an injection technique in which corticosteroid was infiltrated around the patella. Thirty-eight patients with radiologically demonstrable and painful OA of the knee were treated either with peripatellar or intra-articular methylprednisolone in a randomised double blind study. ⋯ Analysis of individual responses showed that the majority of good outcomes were in the peripatellar group. Five patients receiving intra-articular injections but only one receiving a peripatellar injection withdrew because of treatment failure. Peripatellar injection is an alternative method of local administration of corticosteroid which is highly effective in a proportion of patients and merits further evaluation.