Efficacy and Safety of the Combination of Diclofenac and Thiocolchicoside in the Treatment of Low Back Pain and Other Conditions: Systematic Review of the Literature.

IF 2.4 4区 医学 Q2 HEALTH CARE SCIENCES & SERVICES
Ioannis Oikonomou, Karolina Akinosoglou
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引用次数: 0

Abstract

Background/Objectives: Low back pain (LBP) is a leading cause of disability worldwide. Diclofenac, a non-steroidal anti-inflammatory drug (NSAID), and thiocolchicoside, a muscle relaxant, are commonly combined to target inflammation and muscle spasm. However, the efficacy and safety of their combination remain under discussion. This systematic review evaluates the efficacy and safety of diclofenac-thiocolchicoside therapy for LBP and other musculoskeletal conditions. Methods: A systematic review was conducted following PRISMA guidelines. Eligible studies included randomized controlled trials (RCTs) and observational studies comparing diclofenac-thiocolchicoside combination with placebo, monotherapy, or alternative treatments. A search was performed in PubMed, Scopus, and relevant websites, identifying articles published up to 30 September 2024. Studies from trial registries were excluded. Risk of bias was assessed using Revised Cochrane Risk of Bias for randomized trials (RoB 2) for RCTs and the Newcastle-Ottawa Scale (NOS) for observational studies. Evidence certainty was evaluated with the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) framework. Results were visualized using Robvis, tables, and graphs. Results: Of 393 identified records, 9 studies (1097 patients) met the inclusion criteria. Seven RCTs reported significant pain reduction and functional improvement with combination therapy compared to placebo or active controls. However, study heterogeneity, dosage variations, and risk of bias limited comparability. Adverse events (AEs) included gastrointestinal (GI) discomfort and drowsiness, though no severe complications were consistently reported. Conclusions: Despite methodological limitations, the diclofenac-thiocolchicoside combination demonstrates promising efficacy for acute LBP and musculoskeletal pain management. However, there is no clear evidence of its clinical superiority over other available treatments, due to study heterogeneity and potential biases. Rigorous, standardized research with larger sample sizes and consistent methodologies is essential to definitively establish the efficacy and safety of diclofenac-thiocolchicoside, providing clearer guidance for clinical decision-making.

双氯芬酸联合硫代秋糖苷治疗腰痛和其他疾病的疗效和安全性:文献系统综述。
背景/目的:腰痛(LBP)是全球致残的主要原因。双氯芬酸是一种非甾体抗炎药(NSAID),硫代秋糖苷是一种肌肉松弛剂,通常用于治疗炎症和肌肉痉挛。然而,它们联合使用的有效性和安全性仍在讨论中。本系统综述评估了双氯芬酸-硫代秋糖苷治疗腰痛和其他肌肉骨骼疾病的有效性和安全性。方法:按照PRISMA指南进行系统评价。符合条件的研究包括随机对照试验(rct)和比较双氯芬酸-硫代秋糖苷联合治疗与安慰剂、单药治疗或替代治疗的观察性研究。在PubMed、Scopus和相关网站上进行搜索,确定到2024年9月30日发表的文章。试验登记的研究被排除在外。随机对照试验采用修订Cochrane随机试验偏倚风险评估(RoB 2),观察性研究采用纽卡斯尔-渥太华量表(NOS)。采用推荐、评估、发展和评价分级(GRADE)框架评估证据确定性。使用Robvis、表格和图表将结果可视化。结果:在确定的393份记录中,9项研究(1097例患者)符合纳入标准。七项随机对照试验报告了与安慰剂或主动对照相比,联合治疗显著减轻疼痛和功能改善。然而,研究异质性、剂量变化和偏倚风险限制了可比性。不良事件(ae)包括胃肠道(GI)不适和嗜睡,尽管没有严重的并发症持续报道。结论:尽管方法上存在局限性,双氯芬酸-硫代秋糖苷联合治疗急性腰痛和肌肉骨骼疼痛具有良好的疗效。然而,由于研究的异质性和潜在的偏倚,没有明确的证据表明其优于其他可用的治疗方法。严格、标准化、更大样本量和一致方法的研究对于明确确定双氯芬酸硫代秋糖苷的有效性和安全性至关重要,为临床决策提供更明确的指导。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Healthcare
Healthcare Medicine-Health Policy
CiteScore
3.50
自引率
7.10%
发文量
0
审稿时长
47 days
期刊介绍: Healthcare (ISSN 2227-9032) is an international, peer-reviewed, open access journal (free for readers), which publishes original theoretical and empirical work in the interdisciplinary area of all aspects of medicine and health care research. Healthcare publishes Original Research Articles, Reviews, Case Reports, Research Notes and Short Communications. We encourage researchers to publish their experimental and theoretical results in as much detail as possible. For theoretical papers, full details of proofs must be provided so that the results can be checked; for experimental papers, full experimental details must be provided so that the results can be reproduced. Additionally, electronic files or software regarding the full details of the calculations, experimental procedure, etc., can be deposited along with the publication as “Supplementary Material”.
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