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  • Tocopherol acetate...

Tocopherol acetate ointment improves healing rate in chronic anal fissure

Dr. Shravani DaliWritten by Dr. Shravani Dali Published On 2022-03-15T09:00:44+05:30  |  Updated On 2022-03-15T09:01:15+05:30
Tocopherol acetate ointment improves healing rate in chronic anal fissure
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Tocopherol acetate ointment achieved a greater healing rate as compared to glyceryl trinitrate ointment in the management of chronic anal fissure, according to a recent study published in the Diseases of the Colon & Rectum. Medical treatment, including glyceryl trinitrate ointment, represents the first step for the management of chronic anal fissure. However, glyceryl...

Tocopherol acetate ointment achieved a greater healing rate as compared to glyceryl trinitrate ointment in the management of chronic anal fissure, according to a recent study published in the Diseases of the Colon & Rectum.

Medical treatment, including glyceryl trinitrate ointment, represents the first step for the management of chronic anal fissure. However, glyceryl trinitrate ointment is associated with headache and, consequently, a high withdrawal rate of the treatment.

The aim of the present study was to evaluate the effect of the topical application of tocopherol acetate ointment on pain relief and chronic anal fissure epithelialization, comparing it with the effect of standard treatment with glyceryl trinitrate ointment.

This is a 2-parallel-group, single-centre, randomized controlled, intent-to-treat clinical trial. This study was conducted at the Garcilaso Clinic affiliated with Universidad Alfonso X (Madrid, Spain). Patients with chronic anal fissures were selected. Patients were randomly assigned into 2 groups: patients receiving tocopherol acetate ointment and patients receiving glyceryl trinitrate ointment.

The primary endpoint was the quantification of anal pain 8 weeks after beginning the treatment as measured by a Visual Analogue Scale ranging from 0 to 100 mm. The secondary endpoints were the healing rate (during the treatment period of 8 weeks) and the recurrence rate.

The results of the study are:

One hundred sixty consecutive patients were treated, 80 in each group. By 8 weeks after treatment, mean anal pain score declined by 56.2 mm in the glyceryl trinitrate ointment group compared with a mean anal pain score decline of 67.1 mm in the tocopherol acetate ointment group (mean difference, 10.9 mm (95% CI, 4.3–18.6); p = 0.018). Sixteen weeks after finishing the therapy, the recurrence rate was 13.2% in the glyceryl trinitrate ointment group vs 2.9 in the tocopherol acetate ointment group (p = 0.031).

Limitations of the study include the absence of manometric measurements of the internal anal sphincter before and after the treatments and the use of glyceryl trinitrate ointment as an active comparator, whereas calcium channel blockers are actually the standard treatment.

Thus, anal pain was significantly lower in the tocopherol acetate ointment group than in the glyceryl trinitrate ointment group at 8 weeks after treatment. Tocopherol acetate ointment achieved a greater healing rate and a lower recurrence rate 16 weeks after finishing the treatment.

Reference:

Perianal Application of Glyceryl Trinitrate Ointment Versus Tocopherol Acetate Ointment in the Treatment of Chronic Anal Fissure: A Randomized Clinical Trial by Ruiz-Tovar, et al. published in the Diseases of the Colon & Rectum.

https://journals.lww.com/dcrjournal/Abstract/2022/03000/Perianal_Application_of_Glyceryl_Trinitrate.16.aspx


Diseases of the Colon & Rectum Perianal Application Glyceryl Trinitrate Ointment Tocopherol Acetate Ointment Treatment Chronic Anal Fissure 
Source : Diseases of the Colon & Rectum
Dr. Shravani Dali
Dr. Shravani Dali

    BDS

    Dr. Shravani Dali has completed her BDS from Pravara institute of medical sciences, loni. Following which she extensively worked in the healthcare sector for 2+ years. She has been actively involved in writing blogs in field of health and wellness. Currently she is pursuing her Masters of public health-health administration from Tata institute of social sciences. She can be contacted at editorial@medicaldialogues.in.

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