A double-blind, randomized, comparative study of the use of a combination of uridine triphosphate trisodium, cytidine monophosphate disodium, and hydroxocobalamin, versus isolated treatment with hydroxocobalamin, in patients presenting with compressive neuralgias

Abstract

Henrique Goldberg,1 Marco Antonio Mibielli,2 Carlos Pereira Nunes,2 Stephanie Wrobel Goldberg,3 Luiz Buchman,4 Spyros GE Mezitis,5 Helio Rzetelna,6 Lisa Oliveira,2 Mauro Geller,2 Fernanda Wajnsztajn7 1UERJ Medical School, Rio de Janeiro, Brazil; 2UNIFESO Medical School, Teresópolis, Brazil; 3Washington University School of Medicine, St Louis, MO, USA; 4Instituto de Pós-Graduação Médica Carlos Chagas (ICC), Rio de Janeiro, Brazil; 5New York-Presbyterian Hospital/Weill-Cornell Medical Center, New York, NY, USA; 6Santa Casa da Misericórdia do Rio de Janeiro, Rio de Janeiro, Brazil; 7New York-Presbyterian Hospital/Columbia University Medical Center, Neurology, New York, NY, USA Context: This paper reports on the results of treatment of compressive neuralgia using a combination of nucleotides (uridine triphosphate trisodium [UTP] and cytidine monophosphate disodium [CMP]) and vitamin B12.Objectives: To assess the safety and efficacy of the combination of nucleotides (UTP and CMP) and vitamin B12 in patients presenting with neuralgia arising from neural compression associated with degenerative orthopedic alterations and trauma, and to compare these effects with isolated administration of vitamin B12. Methods: A randomized, double-blind, controlled trial, consisting of a 30-day oral treatment period: Group A (n=200) receiving nucleotides + vitamin B12, and Group B (n=200) receiving vitamin B12 alone. The primary study endpoint was the percentage of subjects presenting pain visual analog scale (VAS) scores ≤20 at end of study treatment period. Secondary study endpoints included the percentage of subjects presenting improvement ≥5 points on the patient functionality questionnaire (PFQ); percentage of subjects presenting pain reduction (reduction in VAS scores at study end in relation to pretreatment); and number of subjects presenting adverse events. Results: The results of this study showed a more expressive improvement in efficacy evaluations among subjects treated with the combination of nucleotides + vitamin B12, with a statistically significant superiority of the combination in pain reduction (evidenced by VAS scores). There were adverse events in both treatment groups, but these were transitory and no severe adverse event was recorded during the study period. Safety parameters were maintained throughout the study in both treatment groups.Conclusion: The combination of uridine, cytidine, and vitamin B12 was safe and effective in the treatment of neuralgias arising from neural compression associated with degenerative orthopedic alterations and trauma. Keywords: uridine triphosphate trisodium, cytidine monophosphate disodium, hydroxocobalamin, compressive neuralgia

Keywords

• uridine triphosphate trosodium
• cytidine monophosphate disodium
• hydroxocobalamin
• compressive neuralgia