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IL-1Ra Enriched Serum Relieves Lumbar Compression Pain

Study suggests epidural perineural injection of treated serum is superior to triamcinolone

MONDAY, Aug. 13 (HealthDay News) -- Epidural perineural injection of autologous serum that has been treated to increase the content of interleukin-1 receptor antagonist (IL-1Ra) may be more effective than triamcinolone for the relief of pain of lumbar radicular compression, according to the results of a randomized trial published in the Aug. 1 issue of Spine. IL-1Ra is a natural inhibitor of interleukin-1.

Cordelia Becker, M.D., of the University of Bochum in Germany, and colleagues treated 84 patients with lumbar radicular compression with either triamcinolone or IL-1Ra-enriched serum. The IL-1Ra content of sera was increased about 140-fold using Orthokine, a product in which venous blood is drawn into syringes with treated glass beads and incubated for 24 hours. Patients were treated weekly for three weeks, with five months of follow-up.

Thirty-two patients received epidural perineural injections of conditioned serum, and 52 received triamcinolone (5 mg or 10 mg). Pain intensity, as measured on a visual analog scale, decreased in all treatment arms to a similar extent. But between eight and 12 weeks into the study, the serum-treated group reported an additional decrease in pain intensity, while the triamcinolone group did not. No serious adverse events were reported in any group.

"There was a clear indication that autologous conditioned serum was superior to triamcinolone in the long-term reduction of pain," the authors conclude.

The authors report that no funding was received to conduct the study.

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