What is the evidence for Topical Glyceryl Trinitrate (Nitro patch) for treatment of Achilles Tendinopathy
AMSTAR Rating
Summary
Patient Population:
Patient population:
- 2 studies (105 participants) reviewed the effect of glyceryl trinitrate patches for achilles tendinopathy
- Age>18 (Range: 22-77)
Intervention:
Intervention:
- Glyceryl trinitrate patch (dosage range between 1.25mg/day-2.5mg/day) plus physical therapy
Comparison:
Comparison:
- placebo patch plus physical therapy or just physical therapy alone
Outcome:
Outcome:
- Mixed Results of 2 studies with one finding benefit and the other no significant differences in VAS compared to placebo at 6 months.
- Overall significant findings favouring GTN over placebo were reduced pain at night (12 weeks) and with activity (12 and 24 weeks), local tenderness (12 weeks), increased force and satisfaction and higher chances of being asymptomatic with ADLs (24 weeks) (Level 3 evidence)
Outcomes Assessed
- Benefit
- Harm
- Inconclusive
Pain
With Activity (12 weeks)
At Night (12 weeks)
With Activity (24 weeks)
At Night (24 weeks)
Tenderness
12 weeks
24 weeks
Force Production
24 weeks
Satisfaction with Activities of Daily Living
24 weeks
Relevant Clinical Info
One Randomized double blind placebo controlled trial of 65 participants found the use of Topical GTN dose of 1.25mg/24hr compared to placebo patch showed reduced pain with activity at 12 weeks and 24 weeks. Reduced night pain and reduced tenderness at 12 weeks. Decreased pain scores after the hop test at 24 weeks. Increased ankle plantar flexor mean total work compared to baseline at 24 weeks. 78% were asymptomatic with ADL at 6 months compared to 49% in placebo group.
(Paoloni JA, Appleyard RC, Nelson J, et al. Topical glyceryl trinitrate treatment of chronic noninsertional achilles tendinopathy. A randomized, double-blind, placebo controlled trial. J Bone Joint Surg Am 2004;86-A:86916–22)
Participant Information
of participants
Male
of participants
Female
the sample size was 105
their were 2 studies used.
