Effect of tadalafil on blood flow, pain, and function in chronic cold Complex Regional Pain Syndrome: a randomized controlled trial
This double-blind, randomized, controlled trial investigated the effect of the phosphodiesterase-5 inhibitor tadalafil on the microcirculation in patients with cold Complex Regional Pain Syndrome (CRPS) in one lower extremity.
Methods: Twenty-four patients received 20 mg tadalafil or placebo daily for 12 weeks. The patients also participated in a physical therapy program.
The primary outcome measure was temperature difference between the CRPS side and the contralateral side, determined by measuring the skin temperature with videothermography. Secondary outcomes were: pain measured on a Visual Analogue Scale, muscle force measured with a MicroFet 2 dynamometer, and level of activity measured with an Activity Monitor (AM) and walking tests.
Results: At the end of the study period, the temperature asymmetry was not significantly reduced in the tadalafil group compared with the placebo group, but there was a significant and clinically relevant reduction of pain in the tadalafil group.
Muscle force improved in both treatment groups and the AM revealed small, non-significant improvements in time spent standing, walking, and the number of short walking periods.
Conclusion: Tadalafil may be a promising new treatment for patients that have chronic cold CRPS due to endothelial dysfunction, and deserves further investigation.Trial Registration: The registration number in the Dutch Trial Register is ISRCTN60226869.
Author: George Groeneweg, Frank JPM Huygen, Sjoerd P Niehof, Feikje Wesseldijk, Johannes BJ Bussmann, Fabienne C Schasfoort, Dirk L Stronks and Freek J Zijlstra
Credits/Source: BMC Musculoskeletal Disorders 2008, 9:143
Published on: 2008-10-20
Copyright by the authors listed above - made available via BioMedCentral (Open Access). Please
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