beta-escin and Athletic-Injuries

To investigate the clinical efficacy and safety of escin-containing gels in the topical treatment of blunt impact injuries.. Competitors in soccer, handball, or karate competitions were enrolled within two hours of sustaining a strain, sprain, or contusion and treated three times with the trial gel within a period of eight hours. Patients were randomised to three parallel groups consisting of two active treatment gels, containing escin (1% or 2%), 5% diethylammonium salicylate, and 5000 IU heparin, or placebo gel. Tenderness produced by pressure was measured at 0 (baseline), 1, 2, 3, 4, 6, and 24 hours after enrollment (within two hours of the injury). Tenderness was defined as the amount of pressure (measured by a calibrated caliper at the centre of the injury) that first produced a pain reaction as reported by the patient.. A total of 158 patients were enrolled; 156 were evaluated in the intention to treat analysis. The primary efficacy variable was the area under the curve for tenderness over a six hour period. The gel preparations containing 1% and 2% escin were significantly more effective (a priori ordered hypotheses testing controlling the multiple alpha = 5% significance level) than placebo (p(1) = 0.0001 and p(2) = 0.0002 respectively). The treatment effects were 5.7 kp h/cm(2) (95% confidence interval (CI) 2.9 to 8.5) and 5.9 kilopond (kp) h/cm(2) (95% CI 2.9 to 8.8) between 1% escin and placebo and between 2% escin and placebo respectively. These results were supported by secondary efficacy variables. The time to reach the baseline contralateral tenderness value (resolution of pain) at the injured site was shorter in the treatment groups than in the placebo group (p<0.0001). Both active gel preparations produced more rapid pain relief than the placebo gel. No relevant differences were detected between the two active gels. The safety and tolerability of the escin-containing gels were excellent.. Escin/diethylammonium salicylate/heparin combination gel preparations are effective and safe for the treatment of blunt impact injuries.

Topics: Administration, Topical; Adult; Anti-Inflammatory Agents, Non-Steroidal; Athletic Injuries; Contusions; Double-Blind Method; Drug Combinations; Escin; Female; Gels; Heparin; Humans; Male; Martial Arts; Pain; Salicylic Acid; Soccer; Sprains and Strains; Treatment Outcome; Wounds, Nonpenetrating

The aim of this confirmative, monocentre, double-blind, controlled clinical trial was to investigate whether different escin combinations show differences in comparison to placebo with regard to pain reactions in the topical treatment of sports injuries. A total of 126 patients with blunt injuries of the extremities were randomly allocated to four parallel groups: Reparil-Gel N (n = 32), Reparil-Gel (n = 31), Reparil-Sportgel (n = 32) and a placebo gel (n = 31). All patients were evaluated for efficacy (intention to treat) and tolerability. A per-protocol analysis was also carried out, in which 12 of the 126 patients were excluded due to protocol violations. The intention-to-treat and per-protocol analyses produced similar results. The patients had suffered contusions while participating in soccer, hockey, karate, tae-kwon-do, handball, American football, rugby or tennis. The measured variable was the pressure required at the centre of the lesion to elicit the first pain reaction (tenderness reaction) at measuring time 0 (baseline) and then 1, 2, 3, 4, 6 and 24 h after the injury. The primary variable was the area under the curve (AUC) for tenderness over a six-hour period. The mean AUC differed significantly in the four groups (Kruskal-Wallis test p = 0.0001). Then six pairwise comparisons of two treatment groups each were carried out using the Mann-Whitney test. To control the multiple significance level of 5%, the adjusted p-values according to the Holm-Shaffer method were used in these tests. The three active gels were significantly superior to the placebo gel (Mann-Whitney test, p = 0.0004 in each case) in terms of the AUC. There were no significant differences between the active test substances in terms of the primary variable. The intensity of the pain was also measured on a visual analogue scale (VAS). The pain diminished more rapidly with the Reparil gels than with the placebo. The tolerability of all test substances was good. No adverse events were observed in any of the 126 patients. Escin combination gels are more effective than a placebo and are also well tolerated. Therefore, they can be recommended for the treatment of blunt injuries caused during sports and leisure activities.

Topics: Administration, Topical; Adult; Anti-Inflammatory Agents, Non-Steroidal; Area Under Curve; Arm Injuries; Athletic Injuries; Double-Blind Method; Drug Combinations; Escin; Female; Gels; Humans; Leg Injuries; Male; Pain; Pain Measurement; Patient Satisfaction; Salicylates; Wounds, Nonpenetrating

Topics: Adolescent; Adult; Athletic Injuries; Capillary Permeability; Clinical Trials as Topic; Double-Blind Method; Edema; Escin; Female; Gels; Humans; Male; Middle Aged; Random Allocation; Saponins

Topics: Administration, Topical; Adolescent; Adult; Athletic Injuries; Double-Blind Method; Escin; Female; Gels; Humans; Joints; Male; Middle Aged; Saponins; Wounds, Nonpenetrating

Neck/shoulder, sudden pain, or muscular pain (not associated to structural or bone/joints components), due to fascial or muscular strain is common in active subjects, in non-professional athletes and sports performers. The aim of this supplement registry was the evaluation of a cream based on natural, active ingredients for topical application in supporting the improvement of pain and improving head/neck mobility, possibly minimizing the use of systemic drugs.. The cream includes standardized active ingredients of natural origin as an extract of Harpagophytum procumbes, an extract from Boswellia serrata, a CO2 extract of ginger and escin. Subjects were divided into three groups, all using the standard management (SM) in combination with the Sport Cream or in addition to Flector (diclofenac) patch.. The groups were comparable and homogeneous at the baseline. No side effects or skin tolerability issues were observed with the Sport Cream nor with the SM or diclofenac patches. Subjects receiving sport cream + SM reported a significant improvement in pain, stiffness, altered mobility and altered working capacity, with a reduced need for rescue medication (diclofenac) compared to subjects in the other two groups.. Finally, subjects receiving sport cream + SM reported a more remarkable decrease in skin temperature in the affected area associated to an improvement in clinical symptoms.

Topics: Administration, Topical; Adult; Athletic Injuries; Boswellia; Diclofenac; Escin; Female; Harpagophytum; Humans; Male; Middle Aged; Muscle Tonus; Myalgia; Neck Pain; Pilot Projects; Plant Extracts; Registries; Salvage Therapy; Shoulder Pain; Skin Cream; Thermography; Zingiber officinale

Topics: Adolescent; Adult; Athletic Injuries; Child; Contusions; Drug Combinations; Escin; Heparin; Hesperidin; Humans; Phosphatidylcholines; Time Factors

Topics: Administration, Topical; Adolescent; Adult; Athletic Injuries; Contusions; Drug Combinations; Escin; Female; Flavonoids; Gels; Hesperidin; Humans; Male; Phosphatidylcholines; Saponins; Sprains and Strains

Topics: Adolescent; Adult; Athletic Injuries; Bursitis; Child; Contusions; Drug Combinations; Escin; Female; Hematoma; Heparinoids; Humans; Male; Middle Aged; Nylidrin; Oils, Volatile; Saponins; Skin Temperature; Sprains and Strains; Tendinopathy

Topics: Administration, Topical; Adult; Athletic Injuries; Edema; Escin; Female; Gels; Hematoma; Humans; Male; Muscles; Saponins; Sprains and Strains; Tendinopathy; Thermography