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Pilot study of orphenadrine as a novel treatment for muscle cramps in patients with liver cirrhosis.

ABSTRACT: Muscle cramps markedly affect the quality of life in cirrhotic patients with no available highly effective treatment. The aim of this study was to assess the safety and efficacy of orphenadrine in the treatment of muscle cramps in cirrhotic patients.The study enrolled 30 liver cirrhosis patients complaining of frequent muscle cramps (?3 per week), who were randomized to receive either orphenadrine 100?mg or calcium carbonate 500?mg twice daily as a control for one month. Severity, frequency, and duration of the muscle cramps were assessed before and after treatment as well as recurrence after washout of the drug for two weeks. Side effects were recorded.One month after treatment with orphenadrine; the frequency of muscle cramps decreased significantly to 0.6?±?0.74 per week compared to 12.53?±?6.01 at baseline (p?

SUBMITTER: Abd-Elsalam S

PROVIDER: S-EPMC5949967 | biostudies-literature | 2018 Apr

REPOSITORIES: biostudies-literature

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Pilot study of orphenadrine as a novel treatment for muscle cramps in patients with liver cirrhosis.

Abd-Elsalam Sherief S El-Kalla Ferial F Ali Lobna A LA Mosaad Samah S Alkhalawany Walaa W Elemary Berihan B Badawi Rehab R Elzeftawy Asmaa A Hanafy Amr A Elfert Asem A

United European gastroenterology journal 20170906 3

<h4>Background and aims</h4>Muscle cramps markedly affect the quality of life in cirrhotic patients with no available highly effective treatment. The aim of this study was to assess the safety and efficacy of orphenadrine in the treatment of muscle cramps in cirrhotic patients.<h4>Methods</h4>The study enrolled 30 liver cirrhosis patients complaining of frequent muscle cramps (≥3 per week), who were randomized to receive either orphenadrine 100 mg or calcium carbonate 500 mg twice daily as a con ...[more]

PMID: 29774156

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Project description:ObjectivesTo determine if liver cirrhosis is associated with reduced efficacy of insulin-glucose treatment in moderate to severe hyperkalaemia.DesignRetrospective, cohort study.SettingTwo secondary and one tertiary care hospital at a large metropolitan healthcare network in Melbourne, Australia.ParticipantsThis study included 463 adults with a mean age of 68.7±15.8 years, comprising 79 patients with cirrhosis and 384 without cirrhosis as controls, who received standard insulin-glucose treatment for a serum potassium ≥6.0 mmol/L from October 2016 to March 2020. Patients were excluded if they received an insulin infusion, or if there was inadequate follow-up data for at least 6 hours after IDT due to death, lost to follow-up or inadequate biochemistry monitoring. The mean Model for End-stage Liver Disease score in patients with cirrhosis was 22.2±7.5, and the distribution of the Child-Pugh score for cirrhosis was: class A (24%), class B (46%), class C (30%).Outcome measuresThe primary outcome was the degree of potassium lowering and the secondary outcome was the proportion of patients who achieved normokalaemia, within 6 hours of treatment.ResultsThe mean pretreatment potassium for the cohort was 6.57±0.52 mmol/L. After insulin-glucose treatment, mean potassium lowering was 0.84±0.58 mmol/L in patients with cirrhosis compared with 1.33±0.75 mmol/L for controls (p<0.001). The proportion of patients achieving normokalaemia was 33% for patients with cirrhosis, compared with 53% for controls (p=0.001). By multivariable regression, on average, liver cirrhosis was associated with a reduced potassium lowering effect of 0.42 mmol/L (95% CI 0.22 to 0.63 mmol/L, p<0.001) from insulin-glucose treatment, after adjusting for age, serum creatinine, cancer, pretreatment potassium level, β-blocker use and cotreatments (sodium polystyrene sulfonate, salbutamol, sodium bicarbonate).ConclusionsOur observational data suggest reduced efficacy of insulin-glucose treatment for hyperkalaemia in patients with cirrhosis.

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Pilot study of orphenadrine as a novel treatment for muscle cramps in patients with liver cirrhosis.

Publications

Pilot study of orphenadrine as a novel treatment for muscle cramps in patients with liver cirrhosis.

Similar Datasets

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