Abstract
Introduction: Curcumin, is a natural polyphenol product found in turmeric, and it has primary anti-inflammatory and antioxidative properties. It modulates several molecules in the cell signal transduction pathway to exert the therapeutic benefits. It is widely used to treat multiple medical illnesses and has shown many health advantages. Bromelain, an enzyme obtained from pineapple is shown to promote tendon healing through anti-oxidant and immunosuppressive effects. This study is conducted to assess the effectiveness of Fortend, a drug consisting of MicroActive Curcumin, Epigallocatechin gallatoe Bromelina with Coenzyme Q10, Manganase and Selenium in treating Lateral Epicondylitis (LE).
Materials and Methods: This was a non-controlled, non-randomized retrospective observational clinical study. Records of all patients that were treated for LE in multiple centres between 1st April 2022 to 30th June 2023 with elbow disorders were assessed for eligibility. The inclusion criteria of the study are patients who have been diagnosed clinically to have LE through history, physical examinations and special tests and have been offered at least one course of Fortend. The exclusion criteria include patients with connective tissue disorders, previous history of surgery to the elbow, incomplete follow-up records and/ or without consent. One course of treatment consists of taking one tablet of Fortend per day for 20 days consecutively and a maximum 2 courses are offered based on clinical response. Patients were followed up at 1 month, 3 months and 6 months after initiating Fortend. The outcomes were assessed using Visual Analog Score (VAS) and Disabilities of the Arm, Shoulder, and Hand (DASH) score.
Results: A total of 260 patients that fulfilled the inclusion and exclusion criteria were selected for the study. VAS were 6.9±1.0 at first baseline, 5.6±0.8 at 1month (p=0.03), 3.8±0.6 at 3 months (p<0.001) and 1.7±0.7 at 6 months (p<0.001). DASH scores were 57.8±3.8 at baseline, 41.5±5.8 at 1 month (p<0.001), 26.5±4.6 at 3 months (p<0.001) and 14.6±3.2 at 6 months (p<0.001).
Discussion: Fortend has anti-inflammatory and anti-oxidative properties. It is being used widely in the world to treat many medical illnesses and can be used to treat tendinopathy. This study has shown that the use of Fortend in lateral epicondylitis yields promising results with fast recovery and minimal tolerable side effects. In addition, patients also can avoid any form of injections or surgery for lateral epicondylitis which has inconsistent results.
Conclusion: Fortend is a safe and effective adjunct to conservative treatment of lateral epicondylitis to relieve pain and improving function.
Keywords: Fortend; Tennis Elbow; Anti-inflammatory; Anti-oxidative; Pain
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