RESUMEN
The goal of this paper is to review the pharmacological profile of betahistine and evidence for using it in the treatment of common vestibular disorders. Betahistine is a weak agonist for histamine H1 receptors and strong antagonist for histamine H3 receptors. It demonstrates the maximum benefit in different types of peripheral vertigo, especially in Meniere's disease. The best results in decreasing intensity of vertigo, frequency of attacks and stimulation of vestibular compensation were obtained in daily dose 48 mg during 3 months. In benign paroxysmal positional vertigo betahistine is used to treat residual dizziness after successful treatment of otolithiasis and to reduce the severity of vertigo during repositioning maneuvers. In vestibular neuritis betahistine stimulates central compensation during vestibular rehabilitation. A new once-daily drug formulation of modified-release betahistine is non-inferior to traditional and has a comparable safety profile, and could improve patient adherence. The implication of betahistine in the treatment of central vestibular disorders is under-researched. The efficacy of betahistine in increasing of vestibular compensation in post-stroke central vestibular disorders, persistent postural-perceptual dizziness and its role in vestibular migraine need further investigation.
Asunto(s)
Enfermedad de Meniere , Enfermedades Vestibulares , Vértigo Posicional Paroxístico Benigno , Betahistina , Mareo/etiología , Humanos , Enfermedad de Meniere/diagnóstico , Enfermedad de Meniere/tratamiento farmacológico , Enfermedades Vestibulares/diagnóstico , Enfermedades Vestibulares/tratamiento farmacológicoRESUMEN
OBJECTIVE: To perform a comparative analysis of the efficacy of the original drug meloxicam (movalis) and its generic (amelotex) in the treatment of patients with lower back pain. MATERIALS AND METHODS: The analysis of treatment results of 112 (61 men and 51 women) employees of JSC «Admiralteyskie Verfi¼, aged 18 to 60 years, was carried out. All these patients were treated in the period from 2015 to 2017 at the Medical Center of JSC «Admiralteyskie Verfi¼ due to dorsalgia of lumbosacral localization (ICD-10, item M54). The average age of the patients was 42,6±10,4 (from 22 to 59 years). Age range of patients was 20-35 years (n=34); 36-50 years (n=49); >50 years (n=29). RESULTS: Compared to amelotex, movalis was more effective for the duration of pain intensity reduction (5±1,4 days (min 3, max 9) in the movalis group and 7,37±1,68 days (min 3, max 10) in the amelotex group) as well as for the total duration of temporary disability (labor losses 6,43±1,4 days (min 4, max 10) and 8,61±1,59 days (min 5, max 12), respectively). In addition, patients receiving movalis showed a more significant improvement in the Clinical Global Impression (CGI) score in all age groups compared with patients in the amelotex group. CONCLUSION: The lack of therapeutic equivalence between movalis and amelotex determines the relevance of the drug choice for complex therapy of these patients, which will improve the prognosis of the disease and the quality of life of the patient.