SynthesisPain medicine (Malden, Mass.)2020
Effect of Combined Diclofenac and B Vitamins (Thiamine, Pyridoxine, and Cyanocobalamin) for Low Back Pain Management: Systematic Review and Meta-analysis.
Synthesis in Pain medicine (Malden, Mass.), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06517823 (Efficacy and Safety of the Fixed-Dose Combination of Etoricoxib/Cyanocobalamin Versus Etoricoxib in the Treatment of Patients with Acute Low Back Pain), which is not on this map. Cited by 12 papers.
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.
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.
Efficacy and Safety of the Fixed-Dose Combination of Etoricoxib/Cyanocobalamin Versus Etoricoxib in the Treatment of Patients with Acute Low Back Pain
Who cites it
12 citing papers in PubMed, 60 citations in OpenAlex.
- Adjunctive postoperative vitamin B complex with ibuprofen for pain and soft-tissue healing after impacted mandibular third molar surgery: a split-mouth randomized clinical trial.Oral and maxillofacial surgery · 2026Trial
- A Randomized Control Trial of Dexketoprofen/Vitamin B (Thiamine, Pyridoxine and Cyanocobalamin) Fixed-Dose Combination in Post-Traumatic Grade I-II Cervical Sprains.Clinical drug investigation · 2024Trial
- The Role of Nutrition in Low Back Pain: A Narrative Review and Clinical Implications.American journal of lifestyle medicine · 2025Review
- Efficacy and Safety of the Combination of Diclofenac and Thiocolchicoside in the Treatment of Low Back Pain and Other Conditions: Systematic Review of the Literature.Healthcare (Basel, Switzerland) · 2025Review
- Nutrition interventions for spine-related pain: A scoping review.Biomolecules & biomedicine · 2025Article
- The Protective Effects of Vitamin B Complex on Diclofenac Sodium-Induced Nephrotoxicity: The Role of NOX4/RhoA/ROCK.Inflammation · 2024Article
- The Impact of Nutrition on Pain: A Narrative Review of Recent Literature.Current pain and headache reports · 2024Review
- Diagnosis and Treatment Based on Functional Movement Impairment: A New Model of Functional Restoration Directed to Correction of Pathoanatomic and Pathophysiology of Tissues-Part I.Galen medical journal · 2024Review
- The importance of thiamine (vitamin B1) in humans.Bioscience reports · 2023Article
- Increase in Lower Limb Strength after Multimodal Pain Management in Patients with Low Back Pain.Medicina (Kaunas, Lithuania) · 2022Article
- Effect of vitamin B complex administration on pain and sensory problems related to inferior alveolar nerve damage following mandibular implant placement surgery.Journal of advanced periodontology & implant dentistry · 2022Article
- Acupotomy for third lumbar vertebrae transverse process syndrome: A protocol for systematic review.Medicine · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCumulative evidence suggests an analgesic effect of thiamine, pyridoxine, and cyanocobalamin (TPC) in monotherapy, and also when combined with nonsteroidal anti-inflammatory drugs (NSAIDs), particularly diclofenac, in a synergistic manner. The aim of this review was to determine the effects of diclofenac combined with TPC compared with diclofenac monotherapy for low back pain (LBP) management.
methodsWe searched for randomized clinical trials on the MEDLINE, EMBASE, LILACS, and Cochrane databases of records of clinical trials, among other sources. We evaluated the risk of bias regarding randomization, allocation concealment, blinding, incomplete outcome data, selective reporting, and other biases. A random-effects meta-analysis to examine patients with acute LBP (N = 1,108 adults) was performed, along with a subsequent sensitivity analysis.
resultsFive studies in patients with LBP were included in the qualitative synthesis. Four of these studies in acute LBP were included in the first meta-analysis. A sensitivity test based on risk of bias (three moderate- to high-quality studies) found that the combination therapy of diclofenac plus TPC was associated with a significant reduction in the duration of treatment (around 50%) compared with diclofenac monotherapy (odds ratio = 2.23, 95% confidence interval = 1.59 to 3.13, P < 0.00001). We found no differences in the safety profile and patient satisfaction.
conclusionsThis meta-analysis demonstrated that combination therapy of diclofenac with TPC might have an analgesic superiority compared with diclofenac monotherapy in acute LBP. However, there is not enough evidence to recommend this therapy in other types of pain due to the scarcity of high-quality studies.
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Registered trials
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.