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« on: September 22, 2007, 08:53:08 pm » |
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NEW YORK (Reuters Health) May 04 - Dipyrone is successful in treating acute primary headaches in adults, but its safety remains unclear, according to a report in the Cochrane Database of Systematic Reviews.
Dr. Adriana Ramacciotti and colleagues at the Brazilian Cochrane Center in Sao Paulo note that dipyrone is used in many countries, but is not available in others including the US and UK because of its association with potentially life-threatening blood dyscrasias such as agranulocytosis.
To assess dipyrone's efficacy, the researchers examined data from four double-blind, randomized, controlled trials of the agent. In all, 636 patients were involved.
One study evaluated oral dipyrone for episodic tension-type headache (ETTH), while another employed intravenous dipyrone for ETTH. The two other trials evaluated intravenous dipyrone for migraine, but only one covered pain outcomes.
In both the ETTH trials and the migraine trial, dipyrone was significantly superior to placebo for pain-free and headache improvement outcomes. In one of the ETTH trials, dipyrone 1 g was also found to be more effective than aspirin 1 g.
Two of the trials assessed adverse events. None were serious, and the incidence with dipyrone was not significantly different from that seen with placebo or aspirin.
The researchers point out that they cannot come to a conclusion about the effectiveness of dipyrone in children because of a lack of appropriate trials.
They add that safety is also undetermined, "since 636 patients are too few to assess dipyrone-induced blood disorders." Physicians and patients, they stress, "should be well informed about the risk of blood dyscrasias."
"A study now ongoing in Latin America may clarify the true risk of agranulocytosis associated with dipyrone use," the team concludes.
Cochrane Database Syst Rev 2007;2.
Source: http://www.medscape.com/viewarticle/556085?src=mp
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