METAANALYSIS OF EFFICACY OF QUININE FOR TREATMENT OF NOCTURNAL LEG CRAMPS IN ELDERLY PEOPLE

Objective-To assess quantitatively the efficacy of quinine (as quinine sulphate) compared with placebo in the treatment of nocturnal leg cra mps. Design-A meta-analysis of six randomised, double blind, crossover trials. Setting-Randomised trials that were available as of April 199 4. Subjects-A total of 107 general ambulatory patients who suffered fr om regular nocturnal leg cramps from six clinical trials. Results-Data from individual patients were used to calculate point estimates and 9 5% confidence intervals for each of the outcome measures reported by t hese studies, Treatment with quinine resulted in a significant reducti on in the number of cramps for a four week period compared with placeb o (8.83 fewer cramps; 95% confidence interval 4.16 to 13.49). Treatmen t with quinine reduced the number of nights with cramps by 27.4% (24.0 % to 30.8%) compared with placebo. Treatment did not produce a signifi cant change in the severity or duration of individual nocturnal leg cr amps. Side effects were uncommon. Conclusions-The results indicate tha t quinine can prevent nocturnal leg cramps in general ambulatory popul ations. Given the possible serious side effects of treatment with quin ine, the benefits and risks in patients taking this drug should be clo sely monitored.