Evidence map›Paper›PMID 24587636›Full record

Trial reportWorld journal of gastroenterology2014

Recombinant streptokinase vs phenylephrine-based suppositories in acute hemorrhoids, randomized, controlled trial (THERESA-3).

Francisco Hernández-Bernal, Georgina Castellanos-Sierra, Carmen M Valenzuela-Silva, Karem M Catasús-Álvarez, Roselin Valle-Cabrera, Ana Aguilera-Barreto, Pedro A López-Saura, THERESA-3 Group of Investigators

Open access · hybridAbstract readMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in World journal of gastroenterology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
1.5field-weighted citation impact, top 18% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 12 citations in OpenAlex.

  1. Trial
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 1 institution in 1 country.

Francisco Hernández-BernalFrancisco Hernández-Bernal, Carmen M Valenzuela-Silva, Ana Aguilera-Barreto, Pedro A López-Saura, Center for Genetic Engineering and Biotechnology, Havana 10600, Cuba.
Georgina Castellanos-SierraFrancisco Hernández-Bernal, Carmen M Valenzuela-Silva, Ana Aguilera-Barreto, Pedro A López-Saura, Center for Genetic Engineering and Biotechnology, Havana 10600, Cuba.
Carmen M Valenzuela-SilvaFrancisco Hernández-Bernal, Carmen M Valenzuela-Silva, Ana Aguilera-Barreto, Pedro A López-Saura, Center for Genetic Engineering and Biotechnology, Havana 10600, Cuba.
Karem M Catasús-ÁlvarezFrancisco Hernández-Bernal, Carmen M Valenzuela-Silva, Ana Aguilera-Barreto, Pedro A López-Saura, Center for Genetic Engineering and Biotechnology, Havana 10600, Cuba.
Roselin Valle-CabreraFrancisco Hernández-Bernal, Carmen M Valenzuela-Silva, Ana Aguilera-Barreto, Pedro A López-Saura, Center for Genetic Engineering and Biotechnology, Havana 10600, Cuba.
Ana Aguilera-BarretoFrancisco Hernández-Bernal, Carmen M Valenzuela-Silva, Ana Aguilera-Barreto, Pedro A López-Saura, Center for Genetic Engineering and Biotechnology, Havana 10600, Cuba.
Pedro A López-SauraFrancisco Hernández-Bernal, Carmen M Valenzuela-Silva, Ana Aguilera-Barreto, Pedro A López-Saura, Center for Genetic Engineering and Biotechnology, Havana 10600, Cuba.
THERESA-3 Group of Investigators
Centro de Ingeniería Genética y Biotecnología · CU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimTo compare the efficacy and safety of recombinant streptokinase (rSK) and phenylephrine-based suppositories in acute hemorrhoidal disease.

methodsA multicenter (14 sites), randomized (1:1), open, parallel groups, active controlled trial was done. After inclusion, subjects with acute symptoms of hemorrhoids, who gave their written, informed consent to participate, were centrally randomized to receive, as outpatients, rSK (200000 IU) or 0.25% phenylephrine suppositories, which had different organoleptic characteristics. Treatment was administered by the rectal route, one unit every 6 h during 48 h for rSK, and up to a maximum of 5 d (20 suppositories) for phenylephrine. Evaluations were performed at 3, 5 and 10 d post-inclusion. The main end-point was the 5(th)-day complete clinical response (disappearance of pain and edema, and ≥ 70% reduction of the lesion size). Time to response and need for thrombectomy were secondary efficacy variables. Adverse events were evaluated too.

results5(th) day complete response rates were 83/110 (75.5%) and 36/110 (32.7%) with rSK and phenylephrine suppositories, respectively. This 42.7% difference (95%CI: 30.5-54.2) was highly significant (P < 0.001). The advantage was detected since the early 3(rd) day evaluation (37.3% vs 6.4% for the rSK and active control groups, respectively; P < 0.001) and was kept even at the late 10(th) day assessment (83.6% vs 58.2% for rSK and phenylephrine, respectively; P < 0.001). Time for complete response was significantly shorter (P = 0.031; log-rank test) in the rSK group (median: 4.9 d; 95%CI: 4.8-5.0) with respect to the active control (median: 9.8 d; 95%CI: 9.8-10.0). Thrombectomy was necessary in 1/59 and 8/57 patients with baseline thrombosis in the rSK and phenylephrine groups, respectively (P = 0.016). There were no adverse events attributable to the experimental treatment.

conclusionrSK suppositories showed a significant advantage over a widely used over-the-counter phenylephrine preparation for the treatment of acute hemorrhoidal illness, with an adequate safety profile.

Indexed as

AdolescentAdultAgedFemaleHemorrhoidsHumansMaleMiddle AgedPhenylephrineStreptokinaseSuppositoriesThrombolytic TherapyTreatment OutcomeYoung AdultPhenylephrineStreptokinaseSuppositoriesHemorrhoidsPhenylephrineRandomized clinical trialStreptokinaseSuppositoryThrombolysis

Identifiers

PMID24587636
PMCPMC3925869
OpenAlexW2088648033

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.