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Noguchi40 and poor and fair: 4 patients
357
Effect of Immunomodulating Medications in CRPS
(continued)
TABLE 1. (continued)
Duration
Dirckx et al
358 | www.clinicalpain.com
Zyluk43 OL 36 1-8 mo Methylprednisolone ivrb Overall results, Good: 25 patients; moderate: 8; poor: 3 Poland
graded good, moderate or
poor
Okada et al44 CR 1 >3 mo Methylprednisolone Symptoms were dramatically improved Japan
Taskaynatan RCT 22 3.1 ± 1.4 mo Methylprednisolone ivrb VAS, range of motion and No benefit in both groups Turkey
et al45 vs. placebo volumetric edema
Kalita et al46 RCT 60 7-100 d Prednisolone vs. Oral CRPS score Prednisolone: improvement 83.3%; India
piroxicam Piroxicam: 16.7%
Bianchi et al47 OL 31 10-204 d Prednisone VAS, clinical severity VAS: reduction of score Italy
(scale 0-22) Clinical severity: significant
improvement
Zyluk and OL 75 <4 mo Dexamethasone Intravenous VAS; Loss of finger flexion, Mean VAS decreased; mean loss of finger Poland
Puchalski48 grip strength; flexion decreased, grip strength did not
CRPS score improve; CRPS score decreased
Munts et al49 RCT 21 4.5 y Methylprednisolone Intrathecal Change in pain No effect on pain–>trial The Netherlands
vs. placebo stopped prematurely
TNF-a antagonists
Huygen et al18 CR 2 2-m & 5-y Infliximab Intravenous Clinical examination: pain, 1 slight improvement and 1 considerable The Netherlands
temperature, edema, motor improvement
function
Bernateck et al50 CR 1 3 mo Infliximab Ivrb Pain, temperature, Substantial improvement of pain Germany
hand grip strength, ROM intensity, temperature difference, and
wrist and QST range of motion
Thalidomide
Rajkumar et al51 CR 1 3y Thalidomide Improvement and near resolution of US
symptoms
r
Ching et al52 CR 1 6y Thalidomide Pain and other symptoms disappeared New Zealand
Clin J Pain
58
Siminoski et al CR 1 >1 y Pamidronate Intravenous Pain decrease—>gone Canada
Kubalek et al59 OL 29 41.89 Pamidronate Intravenous Complete disappearance of 25 patients (86.2%) France
± 38.90 wk pain 14 patients (70%)
Functional improvement:
increase in range of
movement more than 20
Robinson et al60 RCT 27 3 mo-6 y Pamidronate vs. Intravenous VAS; patient’s global VAS: overall score was significantly New Zealand
placebo assessment of disease lower and percentage change
severity; functional significantly greater at 3 mo; global
assessment assessment of disease severity score:
overall improvement at 3 mo; physical
function: significantly higher scores at
1 and 3 mo
CR indicates case report; ivrb, intravenous regional block; OL, open label; PVS, pain verbal score; QST, quantitative sensory testing; RCT, randomized controlled trial; RCT1, RCT followed by open label; ROM, range of
motion; VAS, visual analogic scale.
www.clinicalpain.com |
359
Effect of Immunomodulating Medications in CRPS
Dirckx et al Clin J Pain Volume 28, Number 4, May 2012
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