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Adalimumab in severe and acute sciatica: a multicenter, randomized, double-blind, placebo-controlled trial
Stéphane Genevay1, Sebastien Viatte, Axel Finckh
1Hôpital Beau Séjour, University Hospitals of Geneva, Geneva, Switzerland. stephane.genevay@hcuge.ch
Arthritis and Rheumatism
|May 28, 2010
Summary
Adalimumab, a tumor necrosis factor alpha inhibitor, showed a small benefit for radicular pain from lumbar disc herniation, reducing leg pain and surgical procedures.
Area of Science:
- Pain Management
- Rheumatology
- Neurosurgery
Background:
- Radicular pain from lumbar disc herniation significantly impacts patient quality of life.
- Tumor necrosis factor alpha (TNF-a) inhibitors are used in inflammatory conditions, but their role in disc herniation pain is less understood.
Purpose of the Study:
- To evaluate the efficacy of adalimumab as an adjuvant therapy for severe radicular pain caused by lumbar disc herniation.
Main Methods:
- A multicenter, double-blind, randomized controlled trial involved 61 patients with acute, severe radicular leg pain.
- Patients received either adalimumab (40 mg x 2 doses) or placebo, with leg pain assessed via visual analog scale.
Main Results:
- Adalimumab treatment led to a more favorable course of leg pain compared to placebo (P=0.002).
- Significantly more patients in the adalimumab group achieved responder status and had fewer surgical discectomies (6 vs 13).
Conclusions:
- A short course of adalimumab may offer a small reduction in leg pain for acute, severe sciatica.
- Adalimumab treatment was associated with a significant decrease in the need for surgical intervention.
