title: Safety and efficacy of chymopapain (Discase) in the treatment of sciatica due to a herniated nucleus pulposus. Results of a randomized, double-blind study.
abstract: A prospective, multiinstitutional, double-blind trial comparing the effect of chymopapain (Discase) vs. placebo (cysteine-edetate-iothalamate: CEI) for lumbar intervertebral disc rupture with sciatica was carried out on 173 patients, the largest such study reported to date. Patients were matched with respect to age, sex, physical habitus, and level of injection. The procedure was carried out under local anaesthesia. The success rate was superior in the chymopapain group regardless of the method used to assess outcome or the time over the first 6 months at which the two groups were compared: 71% vs. 45% if code breaks were analyzed at 6 months, and 67% vs. 44% if code breaks were defined as lost to follow-up. A single case of anaphylaxis and one case of septic discitis were the only serious complications noted. This study supports the role of chymopapain in the treatment of lumbar disc rupture with sciatica.
authors.affiliation: Division of Neurosurgery, University of Massachusetts Medical Center, Worcester.
authors.forename: E J
authors.initials: EJ
authors.lastname: Dabezies
authors.forename: K
authors.initials: K
authors.lastname: Langford
authors.forename: J
authors.initials: J
authors.lastname: Morris
authors.forename: C B
authors.initials: CB
authors.lastname: Shields
authors.forename: H A
authors.initials: HA
authors.lastname: Wilkinson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000707:Anaphylaxis / Q000139:chemically induced; D002917:Chymopapain / Q000009:adverse effects / Q000627:therapeutic use*; D004311:Double-Blind Method; D004342:Drug Hypersensitivity; D006801:Humans; D007404:Intervertebral Disc Chemolysis; D007405:Intervertebral Disc Displacement / Q000150:complications / Q000188:drug therapy*; D008875:Middle Aged; D009135:Muscular Diseases / Q000139:chemically induced; D011897:Random Allocation; D012585:Sciatica / Q000209:etiology*; D013035:Spasm / Q000139:chemically induced; D013131:Spine
chemical_list: D002917:Chymopapain