Lidocaine patch 5% improves pain, stiffness, and physical function in osteoarthritis pain patients - A prospective, multicenter, open-label effectiveness trial
Lidocaine patch 5% improves pain, stiffness, and physical function in osteoarthritis pain patients - A prospective, multicenter, open-label effectiveness trial
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DOI：
10.1016/j.joca.2003.10.007
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发表时间：
2004-03-01
影响因子：
7
通讯作者：
Sheldon, E
中科院分区：
文献类型：
--
作者：
Burch, F;Codding, C;Sheldon, E
骨关节炎估计影响40万人在美国和70至90%的美国人超过75岁1，2。2000年，与关节炎相关的年度成本（直接医疗费用和工资损失）估计为950亿美元，并且随着其患病率的增加，这一成本将增加1。许多药物干预用于治疗骨关节炎，包括对乙酰氨基酚、非甾体抗炎药（NSAID）或环氧合酶-2（考克斯-2）抑制剂（适用于轻度至中度疼痛）;曲马多或阿片类药物组合用于中度重度疼痛，阿片类药物用于重度疼痛2-4。无论疼痛的严重程度如何，药物单药治疗可能是不够的，患有骨关节炎疼痛的个体通常需要联合治疗5。利多卡因贴片5%，有针对性的外周镇痛剂，已被证明在治疗带状疱疹后神经痛继发性疼痛的疗效6，7。它抑制电压门控钠通道8，这可能有助于骨关节炎疼痛信号传导。在这里，我们报告了一项开放性试验的结果，该试验旨在评估5%利多卡因贴剂在单膝或双膝骨关节炎患者中的有效性，这些患者对稳定剂量的镇痛治疗反应不完全，并确定是否需要进一步的随机对照试验。
Osteoarthritis is estimated to affect 40 million people in the United States and 70 to 90% of Americans over 75 years of age 1, 2. Annual costs associated with arthritis (direct medical expenses and lost wages) were estimated at $95 billion in 2000, and this cost will increase as its prevalence increases 1. A number of pharmacologic interventions are used to manage osteoarthritis, including acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDs), or cyclooxygenase-2 (COX-2) inhibitors as appropriate for mild-to-moderate pain; tramadol or opioid combinations for moderately severe pain, and opioids for severe pain 2–4. Regardless of the pain severity, pharmacologic monotherapy may not be sufficient, and individuals with osteoarthritis pain often require combination therapy 5. The lidocaine patch 5%, a targeted peripheral analgesic, has proven efficacy in the treatment of pain secondary to postherpetic neuralgia 6, 7. It inhibits voltage-gated sodium channels 8, which may contribute to osteoarthritis pain signaling. Here, we report findings of a pilot open-label trial designed to assess effectiveness of the lidocaine patch 5% in patients with osteoarthritis of one or both knees, who had experienced an incomplete response to stable doses of analgesic therapy and to determine if further randomized controlled trials were warranted.