What is the evidence for Topical Glyceryl Trinitrate (Nitro patch) for the treatment of Lateral Epicondylitis
AMSTAR Rating
Summary
Patient Population:
- 280 participants
- Mean age 45.1 years old (Range 19-74 years old)
- Diagnosis of lateral epicondylitis (lateral elbow pain)
Intervention:
- Glyceryl trinitrate patch (dosage range between 0.72mg/day-1.25mg/day) plus rehab
Comparison:
- Placebo patch plus rehab
Outcome:
- Short term outcomes (~6 weeks) : significant differences favouring GTN including reduced pain (Level 3 evidence) and less pain with activity (Level 2 evidence)
- Midterm outcomes (~6 months): significant differences favouring GTN including reduced pain, local tenderness and greater force, chances of being asymptomatic with ADLs (Level 3 evidence) and satisfaction (Level 2 evidence).
Outcomes Assessed
- Benefit
- Harm
- Inconclusive
Pain
Short term (6 weeks)
Midterm (6 months)
Pain with activity
Short term
Midterm
Patient Satisfaction
Short term
Midterm
Asymptomatic with ADL's
Short term
Midterm
Side effects
Headache (up to 63%)
Rash (up to 21%)
Relevant Clinical Info
The largest RCT by Paoloni et al. (Br J Sports Med 2009;43:299–302) contained 154 participants and was stopped after 8 weeks duration. The only difference seen was a statistical benefit to pain with activity in the treatment group v. placebo.
Headache is a common side-effect reported in all three (3) Studies and ranged from 5-63% in the treatment groups, and 10-58% in the control group.
Participant Information
the sample size was 280
Mean age of 45 years.
their were 3 studies used.
