Author:
john
Add date:
09/12/2008
Publishing date:
03/01/2014
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1
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Review
Results
Comment
Analysing visits to the
Bandolier
Internet site showed that quinine and nocturnal leg cramps (
Bandolier 12
) was one of the most frequently viewed pages. So we sought any more recent
information since a meta-analysis published in 1995. A second meta-analysis [1]
was published in 1998, and was interesting because it included unpublished
material and provided some empirical evidence of publication bias.
Review
Searching using three computerised databases was up to July 1997. Unpublished data
was found through examining an FDA report, enquiries to British and German regulatory
authorities, and pharmaceutical companies.
For inclusion studies had to be randomised and double blind, and to be in ambulatory
patients. Information was abstracted on age and sex of patients, treatment duration,
outcome measures, adverse effects and washout periods. The main efficacy outcome was
the reduction in nocturnal leg cramps in a four-week period, severity of cramps, and
their duration.
Results
There were four published studies with 73 patients and three unpublished studies
with 336 patients. The inclusion criteria meant that patients had to have more than
two cramps a week. The dose of quinine was between 200 and 500 mg quinine, and the
treatment period was one to four weeks (two weeks or more in six of the seven
studies). All studies gave the number of cramps, six described their severity, and
only one their duration.
With placebo the number of cramps in a four-week period (by extrapolation if studies
were shorter) was 17 (about four a week) for all studies, 21 in the published studies
and 16 in the unpublished studies (Table 1). Quinine reduced the number of cramps in
a four-week period by 4, 9 and 3 respectively (Table 1). There was also evidence that
the severity of the cramps was reduced.
Table 1: Results of published and unpublished randomised studies of quinine for
nocturnal leg cramps
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