Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
European Spine Journal
Published in: European Spine Journal 4/2013

01-04-2013 | Original Article

Limaprost alfadex and nonsteroidal anti-inflammatory drugs for sciatica due to lumbar spinal stenosis

Authors: Akira Onda, Shin-ichi Kikuchi, Shoji Yabuki, Koji Otani, Takuya Nikaido, Kazuyuki Watanabe, Shin-ichi Konno

Published in: European Spine Journal | Issue 4/2013

Login to get access

Abstract

Purpose

Limaprost, a prostaglandin E1 analog, has vasodilatory properties and increases blood flow of the nerve root. However, it has not been clarified whether limaprost affects pain sensation associated with radiculopathy due to lumbar spinal stenosis (LSS). The aim of this study was to compare the efficacy of oral limaprost with nonsteroidal anti-inflammatory drugs (NSAIDs) for radiculopathy.

Methods

We performed a multicenter prospective randomized trial. Patients with LSS who had radicular-type neurologic intermittent claudication assessed based on a self-reported diagnostic support tool were randomized into three treatment groups. Limaprost, NSAIDs, or limaprost plus NSAIDs were administered orally for 6 weeks. Leg pain, low back pain (LBP) and the associated symptoms were assessed by a numerical rating scale (NRS) both at rest and on movement as well as the Roland–Morris Disability Questionnaire (RDQ) and Short Form (SF)-36.

Results

Sixty-one patients were enrolled in the study. Each treatment finally reduced radicular pain, and the improvement was prominent in a combination treatment. There were no significant differences in radicular pain among three groups at final follow-up. LBP was not influenced by limaprost, and a significant reduction of LBP and RDQ was confirmed in a combination treatment compared with limaprost. Physical function of the SF-36 subscales after a combination treatment showed a marked alleviation compared with NSAIDs.

Conclusions

These obtained findings suggest that the effects of limaprost seem to be limited to radicular pain, not for LBP. Overall, a combination treatment might be more effective in the management of radiculopathy induced by LSS than monotherapy with either agent.
Literature
1.
Baron R, Blinder A (2004) How neuropathic is sciatica? The mixed pain concept (in German). Orthopade 33:568–575PubMedCrossRef
2.
de Graaf I, Prak A, Bierma-Zeinstra S et al (2006) Diagnosis of lumbar spinal stenosis: a systematic review of the accuracy of diagnostic tests. Spine 31:1168–1176PubMedCrossRef
3.
Gauchan P, Andoh T, Kato A et al (2009) Effects of the prostaglandin E1 analog limaprost on mechanical allodynia caused by chemotherapeutic agents in mice. J Pharmacol Sci 109:469–472PubMedCrossRef
4.
Kanai A, Wang G, Hoshi K et al (2010) Effects of intravenous prostaglandin E1 on pain and body temperature in patients with post-herpetic neuralgia. Pain Med 11:609–616PubMedCrossRef
5.
Kikuchi S, Hoshika I, Matui T et al (1986) Neurogenic intermittent claudication in lumbar spine disease; Part 1 (in Japanese). Orthop Surg 37:1429–1438
6.
Kobayashi S, Takeno K, Miyazaki T et al (2008) Effect of arterial ischemia and venous congestion on the lumbar nerve root in dogs. J Orthop Res 26:1533–1540PubMedCrossRef
7.
Konno S, Kayama S, Olmarker K et al (1996) Effects of OP-1206 (prostaglandin E1) on nerve-conduction velocity in the dog cauda equina subjected to acute experimental compression. J Spinal Disord 9:103–106PubMedCrossRef
8.
Konno S, Kikuchi S, Tanaka Y et al (2007) A diagnostic support tool for lumbar spinal stenosis: a self-administered, self-reported history questionnaire. BMC Musculoskelet Disord 8:102PubMedCrossRef
9.
Kurihara A, Kataoka O, Sugawara S et al (1996) Clinical benefit of OP-1206·α-CD on lumbar spinal canal stenosis: multi-center comparative double-blind clinical study (in Japanese). Rinsho Iyaku 12:511–529
10.
Liu Y, Noguchi K, Takenobu Y et al (2002) Comparison the effect of beraprost sodium with that of limaprost alfadex in rat neuropathic intermittent claudication model (in Japanese). Jpn Pharmacol Ther 30:875–880
11.
Liu Y, Obata K, Yamanaka H et al (2004) Activation of extracellular signal-regulated protein kinase in dorsal horn neurons in the rat neuropathic intermittent claudication model. Pain 109:64–72PubMedCrossRef
12.
Mastudaira K, Seichi A, Kunogi J et al (2009) The efficacy of prostaglandin E1 derivative in patients with lumbar spinal stenosis. Spine 34:115–120CrossRef
13.
Murakami M, Takahashi K, Sekikawa T et al (1997) Effects of intravenous lipoprostaglandin E1 on neurogenic intermittent claudication. J Spinal Disord 10:499–504PubMedCrossRef
14.
Nakanishi K, Tanaka M, Misawa H et al (2008) Midterm results of prostaglandin E1 treatment in patients with lumbar spinal canal stenosis accompanied by intermittent claudication. Spine 33:1465–1469PubMedCrossRef
15.
Roelofs PD, Deyo RA, Koes BW et al (2008) Nonsteroidal anti-inflammatory drugs for low back pain: an updated Cochrane review. Spine 33:1766–1774PubMedCrossRef
16.
Sawaragi H, Takenobu Y, Nonaka S et al (1996) Effect of OP-1206 α CD on the thermal hyperesthesia induced by constriction injury to the sciatic nerve in the rat (in Japanese). Kiso to Rinsho 30:237–244
17.
Sekiguchi M, Konno S, Kikuchi S (2006) Effects on improvement of blood flow in the chronically compressed cauda equina: compression between a selective prostaglandin E receptor (EP4) agonist and a prostaglandin E1derivate. Spine 31:869–872PubMedCrossRef
18.
Tsuji H, Tamaki T, Itoh T et al (1985) Redundant nerve roots in patients with degenerative lumbar stenosis. Spine 10:72–82PubMedCrossRef
19.
Uratsuji M, Kurihara A, Iguchi T et al (1996) The optimal dose for OP-1206·α-CD on lumbar spinal canal stenosis: multi-center comparative double-blind clinical study [in Japanese]. Rinsho Iyaku 12:489–509
20.
Yamamoto T, Shimoyama N, Asano H et al (1995) OP-1206, a prostaglandin E1 derivative, attenuates the thermal hyperesthesia induced by constriction injury to the sciatic nerve in the rat. Anesth Analg 80:515–520PubMed
21.
Yoshida K, Sekiguchi M, Otani K et al (2011) A validation study of the Brief Scale for Psychiatric problems in Orthopaedic Patients (BS-POP) for patients with chronic low back pain (verification of reliability, validity, and reproducibility). J Orthop Sci 16:7–13PubMedCrossRef
Metadata
Title
Limaprost alfadex and nonsteroidal anti-inflammatory drugs for sciatica due to lumbar spinal stenosis
Authors
Akira Onda
Shin-ichi Kikuchi
Shoji Yabuki
Koji Otani
Takuya Nikaido
Kazuyuki Watanabe
Shin-ichi Konno
Publication date
01-04-2013
Publisher
Springer-Verlag
Published in
European Spine Journal / Issue 4/2013
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-012-2551-1

Other articles of this Issue 4/2013

European Spine Journal 4/2013 Go to the issue

Original Article

Does nuclear tissue infected with bacteria following disc herniations lead to Modic changes in the adjacent vertebrae?

Original Article

Relevance of intraoperative D wave in spine and spinal cord surgeries

Original Article

Effects of a postural education program on school backpack habits related to low back pain in children

Original Article

HIZ’s relation to axial load and low back pain: investigated with axial loaded MRI and pressure controlled discography

Original Article

Surgical patterns in osteoporotic vertebral compression fractures

Original Article

Physical activity level, leisure activities and related quality of life 1 year after lumbar decompression or total hip arthroplasty