[Optimizing the diagnosis and treatment of dorsalgia in real-world clinical practice: the secondary endpoint of the DORISS multicenter observational study]. / Optimizatsiya diagnostiki i lecheniya dorsalgii v usloviyakh real'noi klinicheskoi praktiki: vtorichnaya konechnaya tochka mnogotsentrovogo nablyudatel'nogo issledovaniya DORISS.

OBJECTIVE: To evaluate the efficacy of Ipigrix in the complex treatment of patients with dorsalgia (DA) of the lumbosacral spine based on the results of the DORISS observational non-interventional multicenter study. MATERIAL AND METHODS: Overall 3563 patients with verified diagnoses of DA at 200 clinical centers within the Russian Federation who received comparable baseline therapy according to nosological standards were examined, some of them additionally received oral or staggered treatment with Ipigrix. Baseline therapy for DA was given to 376 patients (treatment group 1), combination of baseline with oral Ipigrix was given to 1026 patients (group 2), and combination with staggered prescription of ipidacrine - to 2161 (group 3). Secondary endpoint of the study included analysis of the improvement of clinical symptoms, values of pain NRS and DN4 scales together with Roland-Morris questionnaire during the period of observation depending on the therapy with an assessment of its safety. RESULTS: The results of the analysis of covariance allowed to exclude the influence of confounders (age and initial indicators of the utilized scales) on DA outcomes and demonstrated the greatest pain reduction in patients who additionally received Ipigrix via the staggered scheme. The inter-group comparison aligned by pseudorandomization showed statistically significant benefits of combined therapy regardless of the type of Ipigrix administration concerning main vertebral syndrome manifestations, sensory and motor disturbances, relief of pain, as well as neuropathic symptoms, improvement of neurophysiological parameters and restoration of life functioning without serious drug related adverse events. CONCLUSION: Ipigrix (ipidacrine) can be considered an effective and safe adjuvant analgesic in the treatment of DA.

[Optimizing the diagnosis and treatment of dorsalgia in real-world clinical practice: the primary endpoint of the DORISS multicenter observational study]. / Optimizatsiya diagnostiki i lecheniya dorsalgii v usloviyakh real'noi klinicheskoi praktiki: pervichnaya konechnaya tochka mnogotsentrovogo nablyudatel'nogo issledovaniya DORISS.

OBJECTIVE: To evaluate the impact of treatment with Ipigrix on the dynamics of clinical symptoms, neurological status, and quality of life in patients with dorsalgia of the lumbosacral spine based on the DORISS non-interventional multicenter observational study. MATERIAL AND METHODS: A total of 3563 patients with verified diagnoses of low back pain in 200 clinical centers across the Russian Federation who received comparable baseline therapy according to nosological standards were examined, some of whom additionally received oral or staged administration of Ipigrix. The primary endpoint of the study was the description of clinical and sociodemographic parameters, the consumption of medical resources, and the search for optimization of dorsalgia diagnosis in contemporary Russian outpatient neurological practice. RESULTS: The population of patients included in the study represents a homogeneous group of educated, overweight people of working age with average severity of low back pain and related dysfunction. In 91.6% of cases nonspecific mechanisms of pain syndrome development with a moderate neuropathic component prevail in the genesis of back pain, being a reason for seeking medical advice once every 2 months on average. The overdiagnosis of lumbar radiculopathies is discussed, which most probably is of combined nature due to overuse and straightforward interpretation of neuroimaging results, nonsyndromological diagnosis, and classification defects. CONCLUSION: Improving the methods of diagnosis and treatment of patients with PB will reduce the incidence and the number of relapses of pain syndrome.

[A clinical efficacy of electrode pharmaphoresis in treatment of railway workers with low-back pain].

OBJECTIVE: To evaluate clinical efficacy and tolerability of electrode pharmaphoresis using preparations xefocam and mydocalm-richter in railway workers with low-back pain. MATERIAL AND METHODS: Authors carried out an open prospective noncomparative study of 16 patients, aged 21-82 years, with spinal osteochondrosis with root syndrome and radiculopathia of the lumbar/sacral spine with pain syndrome regardless of its duration. Treatment efficacy was assessed by the dynamics of pain syndrome severity based on the scores of a self-rated scale completed by the patient and the McGill Pain Questionnaire. Quality-of-life was assessed with the Oswestry Disability Index before and in the end of treatment. Clinical outcome was evaluated with the modified Nurick scale. Electrode pharmaphoresis (the "Farma T.E.B. Trans Epidermal Barrier Physio" apparatus) was administered to all patients using xefocam (solution for injections 8 mg, 2 ml per procedure) and mydocalm-richter (solution for injections 100 mg, 2 ml per injection) in the lumbar/sacral spine. RESULTS AND CONCLUSION: The high clinical efficacy of electrode pharmaphoresis using xefocam and mydocalm-richter was shown. The complex restoration study resulted in the reduction of pain syndrome in all patients. Pain severity was reduced to mild grade in 68.8% to the middle of treatment and in 93.8% patients in the end of treatment. As a consequence of pain reduction, the functional activity (quality of self-service, daily activities) increased significantly in 68.8% of patients. Positive treatment effect was noted in 100% of patients, good tolerability of this medication in 87.5%.