Our Experience on Actovegin, is it Cutting Edge?

Cardiff University, Institute of Medical Engineering and Medical Physics, Cardiff, United Kingdom.
International Journal of Sports Medicine (Impact Factor: 2.07). 04/2011; 32(4):237-41. DOI: 10.1055/s-0030-1269862
Source: PubMed


Muscle injuries are one of the most common sport related injuries, their incidence varying from 30-55% in all sports injuries. They account for the loss of 90 training days and 15 matches per club per season in elite football (soccer). In recent years, the use of Actovegin® in sports medicine has caused a lot of controversy in many sports disciplines. Although it is unlikely for this deproteinised substance to have oxygen-enhancing capacity, there is an anecdotal belief that Actovegin® can increase an athlete's performance. Actovegin® is produced by Nycomed Austria GmbH and has been used by doctors across Europe, China and Russia for over 60 years. Nevertheless, very little is known regarding the effects of Actovegin on muscle injuries. This article reviews the current evidence on Actovegin®, its legal status with sports governing bodies and its potential role in sport injuries. We will also report our experience with this drug in treating muscle injuries. In this pilot study, players in the Actovegin treatment group were able to return to play 8 days earlier (95% CI -1.249 to -14.7510) compared to physiotherapy alone (p=0.033). No adverse reactions were recorded in any of the participants.

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    ABSTRACT: Actovegin is a deproteinized serum extract of bovine origin, and in recent years it has been used widely in treating sport injuries with many anecdotal reports of success. However, the use of Actovegin in sport medicine has caused a substantial amount of controversy, especially concerning its supposed oxygen-enhancing capacity and an anecdotal belief that its use can increase an athlete's performance. In 2009, a sports physician was arrested with this "performance-enhancing drug," while an editorial in a sports medicine journal strongly questioned the evidence base for using this drug for acute muscle injury. There is also a report that suggested that Actovegin might have induced anaphylactic shock in a cyclist. In this review, we have systematically examined the current evidence on Actovegin. Its mechanism of action, clinical evidence, legal status with sports governing bodies, and its potential role in sport injuries will be discussed.
    Current Sports Medicine Reports 07/2011; 10(4):186-90. DOI:10.1249/JSR.0b013e318223cd8a · 1.55 Impact Factor
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    ABSTRACT: Despite the high rate of hamstring injuries, there is no consensus on their management, with a large number of different interventions being used. Recently several new injection therapies have been introduced. To systematically review the literature on the effectiveness of therapeutic interventions for acute hamstring injuries. The databases of PubMed, EMBASE, Web of Science, Cochrane Library, CINAHL and SPORTDiscus were searched in May 2011. Study eligibility criteria Prospective studies comparing the effect of an intervention with another intervention or a control group without intervention in subjects with acute hamstring injuries were included. Two authors independently screened the search results and assessed risk of bias. Quality assessment of the included studies was performed using the Physiotherapy Evidence Database score. A best evidence synthesis was used to identify the level of evidence. Six studies were included in this systematic review. There is limited evidence for a positive effect of stretching, agility and trunk stability exercises, intramuscular actovegin injections or slump stretching in the management of acute hamstring injuries. Limited evidence was found that there is no effect of non-steroidal anti-inflammatory drugs or manipulation of the sacroiliac joint. There is a lack of high quality studies on the treatment of acute hamstring injuries. Only limited evidence was found to support the use of stretching, agility and trunk stability exercises, intramuscular actovegin injections or slump stretching. Further research is needed using an appropriate control group, randomisation and blinding.
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    ABSTRACT: There is much speculation that Actovegin® is ergogenic, but no scientific work has been published in this field. 8 participants [mean(± SD) age, height and mass of 24 (7) years, 1.76 (0.07) m and 80.1 (9.1) kg, respectively] completed 3 exhaustive arm crank ergometry tests. Following Baseline testing 2 further tests were performed 2 h following the injection of either 40 ml of Actovegin® or a saline Placebo. Peak power (Wpeak), peak physiological responses, concentrations of blood glucose and lactate, exercise efficiency (%), VO2 gain (ml·W-1), and the respiratory compensation point (RCP) were determined. Repeated measures ANOVA tests were used to analyse data with significance accepted at p≤0.05. Values of mean (±90% CI) bias were calculated to further explore quantitative differences between trials. Strong trends for variations in Wpeak (p=0.054) and RCP (p=0.054) were evident; likely meaningful effects existed between the Baseline and both injection trials, but only a trivial effect was noted between Placebo and Actovegin® (bias: Wpeak 0.8±3.2 and RCP; 2.5±4.7 W). Concentrations of blood lactate and glucose changed across time, but did not differ between the 3 trials. Our data suggests the Actovegin® is not ergogenic and did not influence functional capacity in the context of the exhaustive, upper-body test employed.
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