Topical diltiazem ointment versus botulinum toxin A for chronic anal fissure: a double-blind randomized clinical trial: F25

    loading  Checking for direct PDF access through Ovid


Aim:Topical diltiazem and botulinum toxin A (BTA) arepromising treatments for anal fissure but they have never been compared by randomized trial.Method:One hundred and thirty-four patients with a chronic anal fissure were randomized to receive either diltiazem ointment and a placebo injection (group A) or BTA injection and placebo ointment (group B). Theprimary endpoint was fissure healing at 3 months. Secondary endpoints included the pain score, side effects and cost.Results:At 3 months healing occurred in 32 (43%) patients in group A and 26 (43%) in group B. Reduction of more than 50% in the mean pain score was found in 58 (78%) in group A and 49(82%) in group B. Perianal itching was the only side effec and was reported in 15% of patients in group A (P = 0.012). Theprice of group A was €56.80 and €44.39 in group B.Conclusion:Diltiazem and BTA resulted in equal healing rates. No significant difference in pain reduction was observed. In considering cost BTA might be thepreferred initial choice for chronic anal fissure.

    loading  Loading Related Articles