Zeitschrift für Phytotherapie 2013; 34 - P09
DOI: 10.1055/s-0033-1338211

Willow bark extract STW 33-I is safe and effective in the long-term treatment of out-patients with rheumatic pain, esp osteoarthritis or back pain. A subgroup analysis

B Uehleke 1, 2, 3, S Preis 3, J Müller 4, R Stange 1, O Kelber 4, J Melzer 2, 5
  • 1Charité University Medicine Department of Natural Medicine, Königstr. 63, 14109 Berlin, Germany
  • 2University Hospital Zurich, Institute of Complementary Medicine, Rämistr. 10, 8091 Zurich, Switzerland
  • 3University of Health and Sports, Vulkanstr. 1, 10367 Berlin, Germany
  • 4Steigerwald Arzneimittelwerk GmbH, Clinical Research, Havelstr. 5, 64295 Darmstadt, Germany
  • 5University Hospital Zurich, Clinic for Psychiatry and Psychotherapy, Rämistr. 100, 8091 Zurich, Switzerland

Objectives: Degenerative musculoskeletal diseases are of increasing relevance in an ageing population. The efficacy and safety of willow bark extract in the therapy of painful musculoskeletal disorders has been shown in a large number of clinical studies. This 6 months pragmatic surveillance study with STW 33-I (Proaktiv®, extraction solvent water; drug-extract ratio 16 – 23:1) included 436 patients with rheumatic pain mainly due to osteoarthritis and back pain. The patients were treated with STW 33-I monotherapy or in combination with NSAIDs and opioids.

Method: An extensive case report form including pain questionnaires and patient diary was used for outcome evaluation.

Results: All patients started treatment with STW 33-I. 61.5% of the patients (n = 268) took no analgesic comedication. 28.9% (n = 126) took a dual therapy with NSAIDs (mostly diclofenac or ibuprofen) and 3.9% received a triple therapy (STW 33-I + NSAID + opioid). Only 5.7% (n = 25) used other analgesics like gabapentin. The mean change from baseline of the pain intensity score (VAS) was – 22.4 (baseline 58.7) in the subgroup of the patients receiving STW 33-I only, – 18.0 (baseline 56.0) in the STW 33-I + NSAIDs subgroup and – 20.5 (baseline 67.4) in the STW 33-I + NSAIDs + opioids subgroup. These results were comparable to other scales (Likert scale, patients' diary) concerning pain intensity at rest and in motion and pain duration.

The tolerability of STW 33-I was distinctly better compared to the other investigated subgroups. No relevant drug interactions were reported.

Conclusions: These data suggest that the phytomedicinal approach, and especially STW 33-I (Proaktiv®), can be used as a basic treatment in the long-term therapy of degenerative joint diseases and that it can be combined with NSAIDs and opioids if necessary.