{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T18:15:12Z","timestamp":1793297712222,"version":"4.5.0"},"reference-count":42,"publisher":"BMJ","issue":"4","funder":[{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000341","name":"Arthritis Research UK","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000341","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Br J Sports Med"],"accepted":{"date-parts":[[2018,8,21]]},"published-print":{"date-parts":[[2019,2]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To produce a best evidence synthesis of the clinical effects of topical glyceryl trinitrate (GTN) in the treatment of tendinopathies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>A systematic review of published randomised controlled trials (RCTs) of the use of GTN in patients with tendinopathy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data sources<\/jats:title><jats:p>MEDLINE, Embase, Scopus and CINAHL from database inception to January 2018.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We examined RCTs comparing the effects of topical GTN with either placebo or other treatments on tendinopathy. Overall quality of each eligible study was determined based on a combined assessment of internal validity, external validity and precision. The level of evidence for each assessed parameter was rated based on the system by van Tulder<jats:italic>et al<\/jats:italic>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 10 eligible RCTs were identified including patients with tendinopathy of the rotator cuff (n=4), wrist extensors (n=3), Achilles (n=2) and patellar (n=1) tendons. For all tendinopathies, improvements in pain were significant when comparing GTN versus placebo in the short term (&lt;8 weeks; poor evidence). Significant improvements in midterm outcomes for treatment with GTN versus placebo included the following: patient satisfaction (strong evidence); chances of being asymptomatic with activities of daily living (strong evidence); range of movement (moderate evidence); strength (moderate evidence); pain (at night and with activity; poor evidence) and local tenderness (poor evidence). Patients treated with topical GTN reported a higher incidence of headaches than those who received placebo (moderate evidence).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions and relevance<\/jats:title><jats:p>Treatment of tendinopathies with topical GTN for up to 6 months appears to be superior to placebo and may therefore be a useful adjunct to the treating healthcare professions.<\/jats:p><\/jats:sec>","DOI":"10.1136\/bjsports-2018-099552","type":"journal-article","created":{"date-parts":[[2018,10,9]],"date-time":"2018-10-09T17:01:50Z","timestamp":1539104510000},"page":"251-262","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":42,"title":["Topical glyceryl trinitrate for the treatment of tendinopathies: a systematic review"],"prefix":"10.1136","volume":"53","clinical-trial-number":[{"clinical-trial-number":"nct02499484","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Dimitris","family":"Challoumas","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul D","family":"Kirwan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dmytro","family":"Borysov","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Clifford","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"McLean","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9251-9907","authenticated-orcid":false,"given":"Neal L","family":"Millar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2018,10,9]]},"reference":[{"key":"2024100707300570000_53.4.251.1","doi-asserted-by":"publisher","DOI":"10.1002\/art.10841"},{"key":"2024100707300570000_53.4.251.2","doi-asserted-by":"publisher","DOI":"10.1186\/1758-2555-2-30"},{"key":"2024100707300570000_53.4.251.3","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1016\/S0278-5919(20)30507-X","article-title":"Cell-matrix response in tendon injury","volume":"11","author":"Leadbetter","year":"1992","journal-title":"Clin Sports Med"},{"key":"2024100707300570000_53.4.251.4","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-008-0260-1"},{"key":"2024100707300570000_53.4.251.5","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1038\/nrrheum.2016.213","article-title":"Inflammatory mechanisms in tendinopathy - 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