title: Randomised, double-blind, placebo-controlled clinical trial of a new topical glyceryl trinitrate patch for chronic lateral epicondylosis.
abstract: OBJECTIVE
  This study aimed to determine whether a new glyceryl trinitrate patch preparation is effective in treating chronic lateral epicondylosis.
  
  
  METHODS
  Randomised double-blind controlled clinical trial.
  
  
  METHODS
  Private practice
  
  
  METHODS
  154 adult patients with chronic lateral epicondylosis were recruited, with 136 patients completing the trial.
  
  
  METHODS
  8 weeks of glyceryl trinitrate patch application (dosages of 72 mg/24 h, 1.44 mg/24 h, and 3.6 mg/24 h), or placebo patch application.
  
  
  METHODS
  Subjective global assessment of change in elbow symptoms, patient-rated tennis elbow evaluation, visual analogue pain at rest, visual analogue pain with activity, visual analogue pain intensity, grip strength, and strength testing using the Orthopaedic Research Institute-Tennis Elbow Testing System.
  
  
  RESULTS
  At 8 weeks there was a significant decrease in elbow pain with activity in the glyceryl trinitrate 0.72 mg/24 h group compared with placebo (p = 0.04). There were no other significant differences.
  
  
  CONCLUSIONS
  Continuous 1.25 mg/24 h topical glyceryl trinitrate treatment, when combined with daily exercise rehabilitation, has previously demonstrated efficacy in treating chronic lateral epicondylosis. There was significantly decreased elbow pain with activity at 8 weeks in the glyceryl trinitrate 0.72 mg/24 h group (p = 0.04). This short-term dose-ranging study did not demonstrate a treatment effect of a new topical glyceryl trinitrate patch in dosages of 1.44 mg/24 h or 3.6 mg/24 h, which conflicts with previous studies on topical glyceryl trinitrate treatment.
  
  
  BACKGROUND
  NCT00447928.
authors.affiliation: Orthopaedic Research Institute, 2nd Floor, 4 South St, Kogarah, 2217, Research And Education Centre, St George Hospital, Kogarah, Sydney, Australia, 2035. jpaoloni@bigpond.net.au
authors.forename: J A
authors.initials: JA
authors.lastname: Paoloni
authors.forename: G A C
authors.initials: GA
authors.lastname: Murrell
authors.forename: R M
authors.initials: RM
authors.lastname: Burch
authors.forename: R Y
authors.initials: RY
authors.lastname: Ang
mesh_terms: D000279:Administration, Cutaneous; D000293:Adolescent; D000328:Adult; D000368:Aged; D000700:Analgesics / Q000008:administration & dosage*; D002908:Chronic Disease; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D006801:Humans; D008875:Middle Aged; D005996:Nitroglycerin / Q000008:administration & dosage* / Q000009:adverse effects; D013716:Tennis Elbow / Q000188:drug therapy* / Q000534:rehabilitation; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000700:Analgesics; D005996:Nitroglycerin