For all tendinopathies , improvements in pain were significant when comparing GTN versus placebo in the short term ( < 8 weeks ; poor evidence ) .
Significant improvements in midterm outcomes for treatment with GTN versus placebo included the following : patient satisfaction ( strong evidence ) ; chances of being asymptomatic with activities of daily living ( strong evidence ) ; range of movement ( moderate evidence ) ; strength ( moderate evidence ) ; pain ( at night and with activity ; poor evidence ) and local tenderness ( poor evidence ) .
Patients treated with topical GTN reported a higher incidence of headaches than those who received placebo ( moderate evidence ) .
Conclusions and relevance Treatment of tendinopathies with topical GTN for up to 6 months appears to be superior to placebo and may therefore be a useful adjunct to the treating healthcare professions
Objective To produce a best evidence synthesis of the clinical effects of topical glyceryl trinitrate ( GTN ) in the treatment of tendinopathies .
Randomised, double-blind, placebo-controlled clinical trial of a new topical glyceryl trinitrate patch for chronic lateral epicondylosis
Objective : This study aim ed to determine whether a new glyceryl trinitrate patch preparation is effective in treating chronic lateral epicondylosis . Design : R and omised double-blind controlled clinical trial . Setting : Private practice patients : 154 adult patients with chronic lateral epicondylosis were recruited , with 136 patients completing the trial . Interventions : 8 weeks of glyceryl trinitrate patch application ( dosages of 72 mg/24 h , 1.44 mg/24 h , and 3.6 mg/24 h ) , or placebo patch application . Main outcome measures : Subjective global assessment of change in elbow symptoms , patient-rated tennis elbow evaluation , visual analogue pain at rest , visual analogue pain with activity , visual analogue pain intensity , grip strength , and strength testing using the Orthopaedic Research Institute-Tennis Elbow Testing System . Results : At 8 weeks there was a significant decrease in elbow pain with activity in the glyceryl trinitrate 0.72 mg/24 h group compared with placebo ( p = 0.04 ) . There were no other significant differences . Conclusions : Continuous 1.25 mg/24 h topical glyceryl trinitrate treatment , when combined with daily exercise rehabilitation , has previously demonstrated efficacy in treating chronic lateral epicondylosis . There was significantly decreased elbow pain with activity at 8 weeks in the glyceryl trinitrate 0.72 mg/24 h group ( p = 0.04 ) . This short-term dose-ranging study did not demonstrate a treatment effect of a new topical glyceryl trinitrate patch in dosages of 1.44 mg/24 h or 3.6 mg/24 h , which conflicts with previous studies on topical glyceryl trinitrate treatment . Trial registration number : NCT00447928
For all tendinopathies , improvements in pain were significant when comparing GTN versus placebo in the short term ( < 8 weeks ; poor evidence ) .
Significant improvements in midterm outcomes for treatment with GTN versus placebo included the following : patient satisfaction ( strong evidence ) ; chances of being asymptomatic with activities of daily living ( strong evidence ) ; range of movement ( moderate evidence ) ; strength ( moderate evidence ) ; pain ( at night and with activity ; poor evidence ) and local tenderness ( poor evidence ) .
Patients treated with topical GTN reported a higher incidence of headaches than those who received placebo ( moderate evidence ) .
Conclusions and relevance Treatment of tendinopathies with topical GTN for up to 6 months appears to be superior to placebo and may therefore be a useful adjunct to the treating healthcare professions
Objective To produce a best evidence synthesis of the clinical effects of topical glyceryl trinitrate ( GTN ) in the treatment of tendinopathies .