| Efficacy and safety of botulinum toxin a injection compared with topical nitroglycerin ointment for the treatment of chronic anal fissure: a prospective randomized study. | |
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MedLine Citation:
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PMID: 16848808 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: To evaluate the efficacy and safety of botulinum toxin A injection compared with topical nitroglycerin ointment for the treatment of chronic anal fissure (CAF). METHODS: Fifty outpatients with CAF were randomized to receive either a single botulinum toxin injection (30 IU Botox) or topical nitroglycerin ointment 0.2% b.i.d. for 2 wk. If the initial therapy failed, patients were assigned to the other treatment group for a further 2 wk. If CAF still showed no healing at wk 4, patients received combination therapy of botulinum toxin and nitroglycerin for 4 additional wk. Persisting CAF at wk 8 was treated according to the investigator's decision. Healing rates, symptoms, and side effects of the therapy were recorded at wk 2, 4, 8, 12, and 24 after randomization. RESULTS: The group initially treated with nitroglycerin showed a higher healing rate of CAF (13 of 25, 52%) as compared with the botulinum toxin group (6 of 25, 24%) after the first 2 wk of therapy (p < 0.05). At the end of wk 4, CAF healed in three additional patients, all receiving nitroglycerin after initial botulinum toxin injection. Mild side effects occurred in 13 of 50 (26%) patients, all except one were on nitroglycerin. CONCLUSIONS: Nitroglycerin ointment was superior to the more expensive and invasive botulinum toxin injection for initial healing of CAF, but was associated with more but mild side effects. |
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Authors:
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Heiko Fruehauf; Michael Fried; Barbara Wegmueller; Peter Bauerfeind; Miriam Thumshirn |
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Publication Detail:
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Type: Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't Date: 2006-07-18 |
Journal Detail:
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Title: The American journal of gastroenterology Volume: 101 ISSN: 0002-9270 ISO Abbreviation: Am. J. Gastroenterol. Publication Date: 2006 Sep |
Date Detail:
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Created Date: 2006-09-13 Completed Date: 2006-10-19 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0421030 Medline TA: Am J Gastroenterol Country: United States |
Other Details:
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Languages: eng Pagination: 2107-12 Citation Subset: IM |
Affiliation:
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Gastroenterology and Hepatology, Department of Internal Medicine, University Hospital Zurich, Raemistrasse, Zurich, Switzerland. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Administration, Topical Adult Aged Botulinum Toxin Type A / administration & dosage*, therapeutic use Chronic Disease Drug Therapy, Combination Female Fissure in Ano / drug therapy* Follow-Up Studies Humans Injections, Intralesional Male Middle Aged Neuromuscular Agents / administration & dosage*, therapeutic use Nitroglycerin / administration & dosage*, therapeutic use Ointments Prospective Studies Treatment Outcome Vasodilator Agents / administration & dosage*, therapeutic use Wound Healing |
| Chemical | |
Reg. No./Substance:
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0/Botulinum Toxin Type A; 0/Neuromuscular Agents; 0/Ointments; 0/Vasodilator Agents; 55-63-0/Nitroglycerin |
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