Aprotinin not much help for Achilles tendinitis

NEW YORK Apr 8 (Reuters) Australian doctors report that for a strained or inflamed Achilles tendon, injections of aprotinin do not seem to do much to shorten recovery time.

Achilles damage is a common problem for runners, and can be difficult to treat. Symptoms can often persist for more than a year, the researchers note in the British Journal of Sports Medicine.

Because surgery and painkillers are often unsuccessful, sports medicine specialists have turned to aprotinin, a natural substance obtained from bovine lungs that may act as an inhibitor of an enzyme that breaks down collagen.

''Previous studies have shown a significant benefit,'' Dr Richard A Brown from the South Sydney Sports Medicine Center, Kensington, New South Wales told Reuters Health.

To investigate aprotinin's value in treating Achilles tendon damage, Brown and his colleagues assigned 26 patients with the condition to three weekly injections of aprotinin plus local anesthetic, or three saline plus anesthetic injections. All the patients participated in a program of eccentric exercises.

Absolute improvements in Achilles tendon symptoms were greater in the aprotinin group than in the placebo group, the researchers report, but the differences were not statistically significant at any time point up to a year after treatment.

Similarly, the researchers note, none of the secondary outcomes such as tenderness or ''number of hops to pain'' showed significant differences between the two groups.

There was a trend toward a greater occurrence of itch associated with injections in the aprotinin group, the report indicates. None of the patients experienced infections, ruptures, or other significant side effects.

''I would try eccentrics'' and other measures before using aprotinin, Brown advised.

REUTERS PR RN1001