Journal Title: Bolʹ, Sustavy, Pozvonočnik
ISSN: 2224-1507 (Print); 2307-1133 (Online)
Publisher: Zaslavsky O.Yu.
Society/Institution: Ukrainian Association of menopause, andropause and diseases of the musculoskeletal system
LCC Subject Category: Medicine: Medicine (General)
Country of publisher: Ukraine
Language of fulltext: Russian, Ukrainian, English
Full-text formats available: PDF
A.V. Savustyanenko (Donetsk National Medical University named after M. Gorky, Donetsk)
Abstract | Full Text
The review presents the results of studies on clinical efficacy of Harpagophytum procumbens in the treatment of musculoskeletal pain. Pharmacological effects of Harpagophytum procumbens are associated with the inhibition of formation and releasing of proinflammatory cytokines IL-1β, IL-6 and TNF-α from macrophages, inhibition of expression of cyclooxygenase type 2 (COX-2) and inducible NO-synthase (iNOS) in fibroblasts and inhibition of development of lipid peroxidation, all of which lead to the suppression of the inflammatory response and, as result, development of analgesic effect and chondroprotection. Clinical Application. In case of osteoarthritis Harpagophytum procumbens extract (Sustamar) reduced the severity of pain by an average of 25–50 % and increased joint mobility of about 35–50 %; in case of lumbar pain it reduced the severity of pain at 40–50 %, the pain completely disappeared in 2.5–20 % of patients; it was effective in generalized and localized forms of fibromyalgia. Usage of Harpagophytum procumbens extract in case of any musculoskeletal pain was associated with the fact that approximately 60 % of patients reduced the dose or completely stop taking non-steroidal and steroidal anti-inflammatory drugs. It is possible that the efficacy of Harpagophytum procumbens extract corresponds to that of a standard dose of rofecoxib 12.5 mg, however, these data need to be confirmed. Safety. When receiving Harpagophytum procumbens extract, mild side effects (mainly dyspeptic) occurred in approximately 3 % of patients that did not exceed the appropriate frequency occurring in patients receiving placebo. Long-term use of Harpagophytum procumbens extract (up to 1 year) is safe and not associated with the development of toxic effects. Patients’ adherence to the treatment was 96.4 %. The tolerability of Harpagophytum procumbens extract seems to exceed that of selective COX-2 inhibitors. Conclusions. Harpagophytum procumbens extract is an effective and safe agent for the treatment of musculoskeletal pain. For further study of this drug it is necessary to conduct larger studies of higher quality.