Karmakar A, Jaiswal A, Mandal S, Khan AA, Mitra M. Therapeutic efficacy of thiocolchicoside-nonsteroidal anti-inflammatory drug combination in pain management: A systematic review and cross-sectional real-world study. World J Orthop 2025; 16(8): 106769 [PMID: 40838227 DOI: 10.5312/wjo.v16.i8.106769]
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07999314
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August 16, 2025, 18:06
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Reader Comments:
The authors are to be congratulated for providing both a systematic review and real-world evidence, which together highlight the clinical value of this multimodal approach.
The findings clearly demonstrate that TCC-NSAID therapy achieves superior pain relief, functional improvement, and higher patient satisfaction compared with NSAID monotherapy, without a significant rise in adverse events. The observed reduction in postoperative opioid requirements is especially relevant, given the current emphasis on opioid-sparing strategies.
Nonetheless, some caveats merit consideration. The striking imbalance between sample sizes in the real-world dataset (156,713 on NSAIDs alone vs. 492 on TCC-NSAIDs) raises the possibility of sampling bias. Moreover, the substantial heterogeneity reported in functional outcomes and postoperative pain reduction suggests the need for cautious interpretation. Importantly, long-term safety data for TCC remain limited, particularly in patients with hepatic or renal comorbidities, and should be explored further before routine adoption.
Overall, this work adds valuable evidence supporting the synergistic use of TCC with NSAIDs in acute musculoskeletal and postoperative pain
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