The Efficacy of Prostaglandin E1 Derivative in Patients With Lumbar Spinal Stenosis

Matsudaira, Ko; Seichi, Atsushi; Kunogi, Junichi; Yamazaki, Takashi; Kobayashi, Atsuki; Anamizu, Yorito; Kishimoto, Junji; Hoshi, Kazuto; Takeshita, Katsushi; Nakamura, Kozo

doi:10.1097/brs.0b013e31818f924d

Cited by 66 publications

(51 citation statements)

References 26 publications

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“…In a more recent randomized controlled study of limaprost and NSAIDs (etodolac) using the SF-36, Matsudaira et al [9] found that limaprost significantly improved the physical function, role physical, bodily pain, vitality, and mental health categories on the SF-36. Our study indicated similar findings.…”

Section: Discussionmentioning

confidence: 99%

“…The influence of limaprost on QOL has been investigated using the SF-36 health-related QOL scale [7,8] and it has been shown that limaprost significantly improves the SF-36 subscales of physical functioning, role physical, bodily pain, vitality, and mental health, compared to etodolac [9]. However, few studies have examined the effects of limaprost using other health-related QOL scales, and none have used the 5-item EuroQol (EQ-5D), a simple health-related QOL questionnaire [10,1 1].…”

Section: Introductionmentioning

confidence: 99%

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The effect of a prostaglandin E1 derivative on the symptoms and quality of life of patients with lumbar spinal stenosis

Takahashi

Kobayashi

Wakabayashi

et al. 2013

Journal of Orthopaedic Science

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The effect of a prostaglandin E1 derivative on the symptoms and quality of life of patients with lumbar spinal stenosis

Takahashi

Kobayashi

Wakabayashi

et al. 2013

Journal of Orthopaedic Science

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“…An experimental entrapment neuropathy model revealed that PGE 1 led to not only an inhibition of nerve growth factor (NGF) associated with initiation and maintenance of neuronal excitability, but also with an enhancement of vascular endothelial growth factor (VEGF) attributed to an improvement of blood flow at the compressed nerve root lesion 17) . Furthermore, it was reported that in clinical practice, limaprost significantly improved leg numbness, but not low back pain or leg pain, in patients with LSS after an 8 -week intervention in comparison with NSAIDs 20) . These facts are partly in accordance with the observed findings in the current study.…”

Section: Discussionmentioning

confidence: 99%

Comparisons between the efficacy of limaprost alfadex and pregabalin in cervical spondylotic radiculopathy : design of a randomized controlled trial

Onda

Kimura

2018

FJMS

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Background : Cervical spondylotic radiculopathy (CSR) is a relatively common neurological disease caused by the mechanical compression of nerve roots. Limaprost, a prostaglandin E 1 derivative, functions as a vasodilator and has been used in the treatment of lumbar spinal stenosis in Japan. However, the effects of limaprost in cervical radiculopathy remain unclear. Our aim was to compare the efficacy of limaprost with that of pregabalin, which is widely used for the treatment of neuropathic pain. Methods : In this randomized trial, patients with CSR received either limaprost or pregabalin orally for 8 weeks, along with nonsteroidal anti -inflammatory drugs. The primary outcomes were assessed using a numerical rating scale of pain and numbness, both at rest and during movement. Secondary outcomes were assessed using Short Form -36, provocation tests, painDETECT questionnaire, and subjective global assessment. The obtained data were evaluated according to the per -protocol analysis principle. Results : A total of 46 patients were enrolled in this study, and 35 were available for analysis. A greater reduction in pain score was observed in neck pain during movement, and scapular and arm pain both at rest and during movement in the pregabalin -treated group up to 4 weeks. In the limaprost -treated group, numbness of the arm during movement showed a marked alleviation compared to the pregabalin -treated group at 8 weeks. There were no apparent differences between the two groups in terms of the secondary outcomes. Conclusions : Although pregabalin provided an earlier pain relief than limaprost, limaprost was superior to pregabalin in treating arm numbness. Limaprost might be one of the effective therapeutic options for CSR in primary care settings.

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“…Limaprost appeared to be most effective in patients with mild symptoms. No serious AEs were reported 111 . In a second randomized controlled trial in lumbar spinal stenosis, a nasal preparation of salmon calcitonin failed to show any significant benefit over placebo in terms of the Oswestry Disability Index score, VAS for leg pain, and walking distance 112 .…”

Section: Other Agentsmentioning

confidence: 99%

“…Several other agents have been investigated in chronic LBP, all of which have been studied in patients with lumbar spinal stenosis. The efficacy of the vasodilatory prostaglandin E1 derivative limaprost for improving quality of life was examined in a randomized controlled trial in 79 patients with symptomatic lumbar spinal stenosis, in which relative ischaemia of neural tissue is thought to occur 111 . Improvements in the Short Form 36 items Physical Functioning, Role Physical, Bodily Pain, Vitality and Mental Health were significantly greater with limaprost than with the comparator, the NSAID etodolac.…”

Section: Other Agentsmentioning

confidence: 99%

Pharmacotherapy of low back pain: targeting nociceptive and neuropathic pain components

Morlion¹

2010

Current Medical Research and Opinion

115

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Vol. 27, No. 1, 2011, 11-33 To review pharmacological management of chronic low back pain (LBP), with respect to management of nociceptive and neuropathic components. Methods:Studies were identified by a PubMed search of English-language papers from the last 10 years, with additional hand searches of relevant reviews. Discussion:Paracetamol, non-steroidal anti-inflammatory drugs and cyclo-oxygenase-2 inhibitors target the nociceptive component of chronic LBP, and do not affect neuropathic pain mechanisms. Antidepressants target the neuropathic component of chronic LBP; however, conflicting efficacy results have been reported. Opioids target both nociceptive and to a lesser extent neuropathic pain. They are effective in chronic LBP, but many patients require higher doses or combination treatment. The long-term efficacy of opioids in chronic LBP has been questioned because of the absence of high-quality data and concerns regarding tolerability and dependence. The topical preparation lidocaine 5% plaster, indicated in post-herpetic neuralgia, is effective in localized neuropathic pain in patients with chronic LBP. Pregabalin is ineffective as monotherapy for chronic LBP but is effective when combined with celecoxib or opioids. Muscle relaxant monotherapy is ineffective in chronic LBP. Combination therapy is often necessary in patients with chronic LBP, in order to manage both nociceptive and neuropathic pain components. Conclusion:Chronic LBP often comprises both nociceptive and neuropathic components, therefore a multimodal and individualized treatment approach is necessary. Combining drugs with different mechanisms of action (e.g. an agent with m-receptor activity plus an agent of a different class) represents a rational approach to management of chronic LBP with both nociceptive and neuropathic components.

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The Efficacy of Prostaglandin E1 Derivative in Patients With Lumbar Spinal Stenosis

Abstract: In this study, limaprost was found to be efficacious on most outcome measures, such as HRQOL, symptoms and subjective satisfaction, in LSS patents with cauda equina symptoms.

Cited by 66 publications

References 26 publications

The effect of a prostaglandin E1 derivative on the symptoms and quality of life of patients with lumbar spinal stenosis

The effect of a prostaglandin E1 derivative on the symptoms and quality of life of patients with lumbar spinal stenosis

Comparisons between the efficacy of limaprost alfadex and pregabalin in cervical spondylotic radiculopathy : design of a randomized controlled trial

Pharmacotherapy of low back pain: targeting nociceptive and neuropathic pain components

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