Zhou J, et al. - The efficacy of calcitonin was compared with diclofenac sodium in the treatment of patients with nonspecific low back pain (LBP) and type I Modic changes (MC1). Results from this retrospective observational study suggest that calcitonin had greater short-term efficacy compared to diclofenac in these patients.

Methods

• A retrospective observational study with 109 patients who had nonspecific LBP and MC1 that appeared as bone marrow lesions on magnetic resonance imaging (MRI) was done.
• For the treatment of LBP associated with MC1 on MRI, researchers injected 62 patients intramuscularly with calcitonin 50 IU once daily and treated 47 patients with diclofenac 75 mg once per day for 4 weeks between October 2013 and March 2016, .
• Using clinical records, they acquired Visual analog scale (VAS) (0–10) and Oswestry Disability Index (ODI) (0–100) questionnaires to evaluate LBP perception and degree of disability.
• Before and after treatment, imaging data were collected.

Results

• Both groups displayed significant improvement in VAS and ODI posttreatment compared with baseline (P < 0.05).
• Calcitonin group and diclofenac group showed significant difference at both 4 weeks and 3 months of follow-up (4 weeks: VAS 4.46 ± 1.58 vs 5.08 ± 1.50, ODI 20.32 ± 9.64 vs 24.35 ± 7.95; 3 months: VAS 3.70 ± 1.74 vs 4.51 ± 1.67, ODI 16.67 ± 9.04 vs 21.18 ± 9.56; P < 0.05 for all).
• The calcitonin group had higher proportion of patients with a significant change in LBP scales (4 weeks: VAS 50.00% vs 23.40%, ODI 54.83% vs 25.53%; 3 months: VAS 58.06% vs 38.29%, ODI 59.67% vs 38.29%; P < 0.05 for all).
• According to MRI, improvement was evident in 43.54% patients in the calcitonin group compared with 21.27% patients in the diclofenac group (P < 0.05).