Über den Wert der Anwendung von Dexamethasonphosphat in der konservativen Therapie der Lumboischialgie

Hofferberth, B.; Gottschaldt, M.; Graß, Hildegard

doi:10.1007/978-3-642-68974-1_63

Cited by 1 publication

(7 citation statements)

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“…A total of 1,550 articles were retrieved from the searches, of which nine studies were eligible ( Figure 1) (Balakrishnamoorthy, Horgan, Perez, Steele, & Keijzers, 2015;Friedman, Esses, & Solorzano, 2008;Goldberg, Firtch, & Tyburski, 2015;Hedeboe, Buhl, & Ramsing, 1982;Haimovic & Beresford 1985;Hofferberth, Gottschaldt, Grass, & Buttner, 1982;Holve & Barkan 2008;Porsman & Friis 1979;Ropper & Zafonte 2016). Each study had <300 participants.…”

Section: Resultsmentioning

confidence: 99%

“…Eligible studies evaluated a single intramuscular injection (IMI) of methylprednisolone acetate 160 mg (Friedman et al, 2008) IMI dexamethasone (7-day tapering course starting at 64 mg (Hedeboe et al, 1982;Porsman & Friis 1979;) or 10-day tapering course starting at 8 mg (Hofferberth et al, 1982), a single IV bolus of methylprednisolone sodium succinate 500 mg (Finckh et al, 2006), or IV dexamethasone 8 mg (Balakrishnamoorthy et al, 2015) oral dexamethasone (7-day tapering course starting at 64 mg) (Haimovic & Beresford 1985) and oral prednisone (9-day tapering course starting at 60 mg (Holve & Barkan 2008) or 15-day tapering course starting at 60 mg (Goldberg et al, 2015). The characteristics of glucocorticoids and dosing information are summarised in Table A3.…”

Section: Treatment Regimensmentioning

confidence: 99%

“…Four studies (Finckh et al, 2006;Friedman et al, 2008;Goldberg et al, 2015;Holve & Barkan 2008) provided specific information about the duration of symptoms at the time of drug administration. This ranged from 72 hr in one study of IMI methylprednisolone 160 mg (Friedman et al, 2008), with study authors citing the view that the intervention was most likely to work when administered early, to 276 months in another (Hofferberth et al, 1982). Some studies provided unclear information on the duration of symptoms (Balakrishnamoorthy et al, 2015;Haimovic & Beresford 1985;).…”

Section: Symptom Duration At the Time Of Therapymentioning

confidence: 99%

“…Clinical investigation was the dominant method used to confirm sciatica, with a positive straight leg test (positive Lasègue) featured in all but two studies (Goldberg et al, 2015;Hofferberth et al, 1982) Pain radiating below the knee and motor or sensory deficits were also common eligibility criteria. In two studies (Finckh et al, 2006;Goldberg et al, 2015) participants had radiographically confirmed disc herniation (via MRI, computerised tomography) and in another study (Hofferberth et al, 1982) participants with confirmed disc herniation (positive myelogram) were excluded. Friedman et al, 2008;Goldberg et al, 2015) four had unclear risk (Haimovic & Beresford 1985;Hedeboe et al, 1982;Hofferberth et al, 1982;Porsman & Friis 1979;) and one (Holve & Barkan 2008) high risk (eFigure 1).…”

Section: Characteristics Of Sciaticamentioning

confidence: 99%

“…The adverse events reported in the RCTs included glucocorticoid-specific adverse events, for example, hyperglycaemia, mood changes, dyspepsia were reported in six studies (see Table A5 for description of AEs reported) (Finckh et al, 2006;Friedman et al, 2008;Goldberg et al, 2015;Hedeboe et al, 1982;Hofferberth et al, 1982;Porsman & Friis 1979;). The severity of AEs was described as mild by study authors.…”

Section: Adverse Events (Ae)mentioning

confidence: 99%

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Efficacy and harms of orally, intramuscularly or intravenously administered glucocorticoids for sciatica: A systematic review and meta‐analysis

Shaheed

Maher

Buchbinder

et al. 2020

European Journal of Pain

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Background Sciatica can be a debilitating condition and there is limited guidance on the use of glucocorticoids administered via the oral, intramuscular or intravenous route for this condition. These represent viable treatment options in the primary care setting. Objective To evaluate the evidence on efficacy and harms of oral, IM and IV glucocorticoid administration for sciatica. Databases and data treatment MEDLINE, EMBASE, CENTRAL, CINAHL, PsycINFO (inception to October 2018) were searched for randomised placebo‐controlled trials evaluating oral, IV or IM glucocorticoid administration for sciatica. Two authors extracted outcomes data. Continuous pain and disability outcomes were converted to a 0 (no pain/disability) to 100 (worst pain/disability) scale. Data were pooled using a random effects model. Overall quality of evidence was assessed using GRADE. Primary outcomes were leg pain and disability. Primary follow‐up period was the immediate‐term (<2 weeks from administration). We also considered adverse events. Results Nine trials were eligible. One study [n = 27] provided low quality evidence of a small reduction in disability with early administration of oral prednisone (within 1 week); MD −13.4 [−23.3, −3.5] but not for pain MD −2.5 [−16.9, 11.9]. There was low quality evidence from one study [n = 78] of moderate reduction in disability and small reduction in pain with early (within 72 hr of symptom onset) single intramuscular administration of methylprednisolone acetate; MD −24.5 [−38.8, −10.2] and −14.0 [−27.4, −0.6], respectively. There were no immediate‐term benefits with IV administration. Conclusion The effects of glucocorticoids on immediate‐term leg pain or disability are uncertain. Future large high quality trials are needed to resolve this uncertainty.

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