Page 18 - pest-POSTEN nr 1-2, 2020

-pest-POSTEN Side 18

Doktorgrad

Antibiotikabehandling
mot ryggsmerter
Lars Christian Bråthen Illustrasjon: Colourbox

disputerte for ph.d-graden
den 21. januar 2020 ved
amoxicillin/clavulanate treatment provide a
Universitetet i Oslo large effect for patients with chronic low back
pain and Modic changes. This led to increased
antibiotic treatment for low back pain. The
scientific environment required that the results
should be replicated in further trials before
treatment guidelines could be changed for this
patient group.
This thesis is based on the AIM-study (Antibiotics
in Modic changes) that was initiated to reassess
the results of the 2013-trial. At six Norwegian
hospitals, a total of 180 patients with chronic low
back pain and Modic changes were randomized
to 100 days of encapsulated amoxicillin or
placebo. All patients, trial staff, researchers and
statisticians were blinded to the treatment group.
The results showed that there were no clinically
significant differences between the antibiotic
Thesis title: Chronic low back pain with Modic group and the placebo group in patient reported
changes - Antibiotic treatment and clinical outcome measures of disability, pain intensity
characteristics. or quality of life at one year follow-up. Neither
were there any clinically relevant differences
Main supervisor: Seksjonsleder Kjersti in subgroups of patients, defined by the type of
Storheim, Forsknings- og formidlingsenheten for Modic changes or clinical information.
muskelskjeletthelse (FORMI), Oslo University
Hospital. In addition, it was investigated whether patients
with type 1 Modic changes (oedema type) have
First opponent: Professor emeritus Peter Croft, different clinical outcomes and measurements
Keele University, Staffordshire, United Kingdom compared to patients with type 2 Modic changes
Second opponent: Professor Raymond WJG (fatty type). No relevant differences were found
Ostelo, Vrije Universiteit, Amsterdam, The between patients with these types of Modic
Netherlands changes.
Modic changes are vertebral changes extending The key message from this thesis is that the
from the endplate visible on an MRI, and results of the AIM-study did not support the use
are associated with back pain. A randomized of antibiotic treatment for chronic low back pain
trial from 2013 concluded that 3 months oral and Modic Changes.