Aceclofenac-tizanidine in the treatment of acute low back pain: a double-blind, double-dummy, randomized, multicentric, comparative study against aceclofenac alone.

Tizanidine and aceclofenac individually have shown efficacy in the treatment of low back pain. The efficacy and tolerability of the combination have not yet been established. The objective of the study was to evaluate the efficacy and safety of aceclofenac-tizanidine fixed dose combination against aceclofenac alone in patients with acute low back pain. This double-blind, double-dummy, randomized, comparative, multicentric, parallel group study enrolled 197 patients of either sex in the age range of 18-70 years with acute low back pain. The patients were randomized to receive either aceclofenac (100 mg)-tizanidine (2 mg) b.i.d or aceclofenac (100 mg) alone b.i.d for 7 days. The primary efficacy outcomes were pain intensity (on movement, at rest and at night; on VAS scale) and pain relief (on a 5-point verbal rating scale). The secondary efficacy outcomes measures included functional impairment (modified Schober's test and lateral body bending test) and patient's and investigator's global efficacy assessment. aceclofenac-tizanidine was significantly superior to aceclofenac for pain intensity (on movement, at rest and at night; P < 0.05) and pain relief (P = 0.00) on days 3 and 7. There was significant increase in spinal flexion in both the groups from baseline on days 3 and 7 with significant difference in favour of the combination group (P < 0.05). There were significantly more number of patients with excellent to good response for the aceclofenac-tizanidine treatment as compared to aceclofenac alone (P = 0.00). Both the treatments were well tolerated. In this study, aceclofenac-tizanidine combination was more effective than aceclofenac alone and had a favourable safety profile in the treatment of acute low back pain.
AuthorsAnil Pareek, Nitin Chandurkar, A S Chandanwale, Ratnakar Ambade, Anil Gupta, Girish Bartakke
JournalEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society (Eur Spine J) Vol. 18 Issue 12 Pg. 1836-42 (Dec 2009) ISSN: 1432-0932 [Electronic] Germany
PMID19421791 (Publication Type: Comparative Study, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
Chemical References
  • Analgesics
  • Anti-Inflammatory Agents, Non-Steroidal
  • Drug Combinations
  • Diclofenac
  • tizanidine
  • Clonidine
  • aceclofenac
  • Activities of Daily Living
  • Acute Disease (therapy)
  • Adolescent
  • Adult
  • Aged
  • Analgesics (administration & dosage, adverse effects)
  • Anti-Inflammatory Agents, Non-Steroidal (administration & dosage, adverse effects)
  • Clonidine (administration & dosage, adverse effects, analogs & derivatives)
  • Diclofenac (administration & dosage, adverse effects, analogs & derivatives)
  • Double-Blind Method
  • Drug Administration Schedule
  • Drug Combinations
  • Drug Therapy
  • Drug Therapy, Combination
  • Female
  • Humans
  • Low Back Pain (drug therapy, physiopathology)
  • Male
  • Middle Aged
  • Mobility Limitation
  • Movement (drug effects)
  • Outcome Assessment (Health Care)
  • Pain Measurement (drug effects)
  • Pain Threshold (drug effects)
  • Patient Satisfaction
  • Placebo Effect
  • Range of Motion, Articular (drug effects, physiology)
  • Treatment Outcome
  • Young Adult

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