Department of Anesthesiology, Duke University School of Medicine, Durham, NC, USA; Anesthesiology Service, Durham VA Medical Center, Durham, NC, USA.
Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC, USA.
Complement Ther Clin Pract. 2024 Nov;57:101908. doi: 10.1016/j.ctcp.2024.101908. Epub 2024 Sep 15.
Opioid abuse and mortality are ravaging American society, highlighting the need to find alternative effective analgesics with fewer side effects. FDA-approved topical analgesics, including non-steroidal anti-inflammatory drugs (NSAIDs), are commonly used to treat musculoskeletal pain but can cause adverse effects. Natural compounds, including essential oils, are potential therapeutic alternatives for managing musculoskeletal pain. If these compounds can provide comparable analgesia to FDA-approved products, it will increase the available options for people with pain, improving quality of life with minimal morbidity and mortality.
This study assesses the effectiveness and onset of action of Bonipar, a topical analgesic formulated with camphor, methyl salicylate, and oils of coconut, eucalyptus, nutmeg, and rosemary, in managing musculoskeletal pain compared to 1.5 % diclofenac solution, an FDA-approved topical non-steroidal anti-inflammatory drug.
One hundred sixty-four adult patients with localized musculoskeletal pain were randomly assigned to twice-daily applications of either Bonipar or Diclofenac for one week. The primary outcome measure was a 50 % reduction in pain after one week. Secondary outcomes included the change in pain from baseline and onset of action, defined as the first reduction in pain by 20 %.
All patients completed the initial pain assessment to determine the onset of action. One-week data was available for 74 patients treated with diclofenac and 72 patients treated with Bonipar. Data for 18 patients were incomplete. The proportion of patients achieving a 50 % reduction in pain was statistically similar between the two groups. The success rates of achieving a 50 % pain reduction with Bonipar were found to be non-inferior to those treated with diclofenac. All follow-up time points showed roughly similar results between the groups. Regression models adjusted for age and sex revealed no significant effects on pain changes. Secondary analyses demonstrated no significant differences between the groups.
The topical analgesic Bonipar demonstrates a comparable onset of action, with efficacy non-inferior to diclofenac in the management of musculoskeletal pain, while showing fewer adverse effects compared to diclofenac. These findings highlight the potential of Bonipar as a valuable alternative for the treatment of localized pain.
阿片类药物滥用和死亡率正在肆虐美国社会,这凸显了寻找具有较少副作用的替代有效镇痛剂的必要性。美国食品和药物管理局批准的外用镇痛药,包括非甾体抗炎药(NSAIDs),常用于治疗肌肉骨骼疼痛,但可能会引起不良反应。天然化合物,包括精油,是管理肌肉骨骼疼痛的潜在治疗替代方法。如果这些化合物可以提供与美国食品和药物管理局批准的产品相当的镇痛效果,那么这将为疼痛患者提供更多选择,提高生活质量,同时最大限度地减少发病率和死亡率。
本研究评估了一种新型外用镇痛药 Bonipar(由樟脑、水杨酸甲酯和椰子油、桉树油、肉豆蔻油和迷迭香油制成)与美国食品和药物管理局批准的外用非甾体抗炎药 1.5%双氯芬酸钠溶液相比,在治疗肌肉骨骼疼痛方面的有效性和起效时间。
164 名患有局部肌肉骨骼疼痛的成年患者被随机分配,每天两次应用 Bonipar 或 Diclofenac,持续一周。主要观察指标为一周后疼痛减轻 50%。次要结果包括疼痛从基线的变化和起效时间,定义为疼痛减轻 20%的首次时间。
所有患者均完成了初始疼痛评估以确定起效时间。接受双氯芬酸钠治疗的 74 例患者和接受 Bonipar 治疗的 72 例患者可获得一周的数据。18 例患者的数据不完整。两组患者中达到疼痛减轻 50%的比例在统计学上无显著差异。Bonipar 治疗组达到 50%疼痛缓解的成功率被证明不劣于双氯芬酸钠治疗组。所有随访时间点两组之间的结果大致相似。调整年龄和性别后,回归模型显示疼痛变化无显著影响。次要分析显示两组之间无显著差异。
外用镇痛药 Bonipar 的起效时间相当,在治疗肌肉骨骼疼痛方面的疗效不劣于双氯芬酸钠,且不良反应少于双氯芬酸钠。这些发现突显了 Bonipar 作为局部疼痛治疗的有价值替代药物的潜力。