Tenex (guanfacine immediate release tablet) / Dr. Reddy’s - LARVOL DELTA

A Systematic Review of Post-Procedural Rehabilitation Protocols following Percutaneous Needle Tenotomy and Ultrasonic Debridement for Gluteal, Proximal Hamstring, and Patellar Tendinopathy. (PubMed, Am J Phys Med Rehabil) - "PNT and UD appear effective for managing refractory tendinopathy, yet post-procedure rehabilitation guidelines remain inconsistent and supported by limited high-quality evidence. Future research should aim to identify key variables that guide individualized rehabilitation progressions, optimizing recovery timelines, and facilitating safe and efficient return to activity following PNT and UD procedures."

Journal

Randomized Controlled Trial (RCT) of Open Debridement Versus Tenex (clinicaltrials.gov) - P=N/A | N=90 | Recruiting | Sponsor: Sean Mc Millan | Trial completion date: Jun 2026 ➔ Dec 2028 | Trial primary completion date: Dec 2025 ➔ Dec 2027

Trial completion date • Trial primary completion date • Musculoskeletal Pain • Orthopedics

RCT GTPS: Evaluation of TENEX for Greater Trochanteric Pain Syndrome (GTPS) (clinicaltrials.gov) - P=N/A | N=150 | Recruiting | Sponsor: Montefiore Medical Center | Trial completion date: Mar 2027 ➔ Dec 2028 | Trial primary completion date: Mar 2027 ➔ Dec 2028

Trial completion date • Trial primary completion date • Musculoskeletal Pain • Pain

A Tale of Two Shoulders: Comparative Outcomes of Coracohumeral Ligament Release With and Without Percutaneous Peripheral Nerve Stimulation in Adhesive Capsulitis. (PubMed, Pain Med Case Rep) - "Our case highlights the evolving treatment landscape of AC and underscores the need for further research into the optimal roles of Tenex and PNS in its management."

Journal • Pain

Effect of Guanfacine on Opioid-induced Hyperalgesia (OIH) and Tolerance (clinicaltrials.gov) - P4 | N=137 | Terminated | Sponsor: Massachusetts General Hospital | N=200 ➔ 137

Enrollment change • Pain

Effect of Guanfacine on the Reversal of Opioid-induced Hyperalgesia (OIH) (clinicaltrials.gov) - P=N/A | N=8 | Terminated | Sponsor: Massachusetts General Hospital | N=120 ➔ 8

Enrollment change • Pain

Ultrasound-Guided Percutaneous Needle Tenotomy (PNT) vs Percutaneous Ultrasonic Needle Tenotomy (PUT) for Gluteal Tendinosis (clinicaltrials.gov) - P=N/A | N=110 | Not yet recruiting | Sponsor: University of Colorado, Denver

New trial

Attention-Deficit/Hyperactivity Disorder and Disruptive Behavior in a Child With Eosinophilic Esophagitis and Failure to Thrive. (PubMed, J Dev Behav Pediatr) - "Behavioral therapy, IEP evaluation, and trial of ADHD medication were recommended.Given his poor weight gain and inability to swallow tablets, a nonstimulant, guanfacine immediate release (IR) was initiated...An extended-release oral liquid methylphenidate stimulant was started in conjunction with guanfacine and resulted in significant improvement of ADHD symptoms...Several months later, Ryan endorsed missing his friends and wanting to go back to school. He agreed to sign a behavioral contract stating that if he returned to school, he would not sneak/steal food.What are some recommendations to consider for addressing Ryan's behavioral challenges?"

Journal • ADHD (Impulsive Aggression) • Anesthesia • Attention Deficit Hyperactivity Disorder • Behavior Disorders • CNS Disorders • Eosinophilic Esophagitis • Gastrointestinal Disorder • Immunology • Pediatrics • Psychiatry

Ultrasound-Guided Ossicle Excision for Chronic Osgood-Schlatter Disease and Sinding-Larsen-Johansson Syndrome: A Case Series and Review of the Literature. (PubMed, Clin J Sport Med) - "This case series is the first to describe an ultrasound-guided technique for excision of chronic, symptomatic OSD and SLJS ossicles. The approach demonstrated rapid recovery, excellent pain relief, and favorable functional outcomes. Further prospective studies with larger cohorts are warranted to validate efficacy and long-term safety."

Journal • Anesthesia • Musculoskeletal Pain • Orthopedics • Pain

2-Year clinical outcomes following combined iliotibial band and gluteus medius percutaneous ultrasound tenotomy in refractory GTPS. (PubMed, Interv Pain Med) - "Subsequent invasive interventions were required in a minority of cases (2.5 % total hip arthroplasty; 11.4 % repeat TENEX)...Despite declining responder rates over time, this minimally invasive dual-target technique demonstrates a favorable safety profile and may delay or reduce the need for more invasive surgery. Further prospective studies are warranted to optimize patient selection and validate long-term efficacy."

Clinical data • Journal • Musculoskeletal Pain • Orthopedics • Pain

A stratified precision medicine trial targeting α2A-adrenergic receptor agonism as a treatment for the cognitive biotype of depression. (PubMed, Nat Ment Health) - P4 | "Here, in line with a precision medicine approach, we evaluated guanfacine immediate release (GIR), an α2A receptor agonist, as a novel treatment aimed at enhancing cognitive control circuit function and behavioral performance in a neurobiologically defined subtype of depression, the cognitive biotype NCT04181736...GIR also led to significant improvements in cognitive control performance, global life satisfaction and quality of life. Here we demonstrate both clinical efficacy and circuit target engagement of GIR as a mechanistically selective treatment for the cognitive biotype of depression."

Journal • Alzheimer's Disease • CNS Disorders • Cognitive Disorders • Depression • Major Depressive Disorder • Mood Disorders • Psychiatry

Effect of Guanfacine on the Reversal of Opioid-induced Hyperalgesia (OIH) (clinicaltrials.gov) - P=N/A | N=120 | Terminated | Sponsor: Massachusetts General Hospital | Active, not recruiting ➔ Terminated; End of NIH funding

Trial termination • Pain

Effect of Guanfacine on Opioid-induced Hyperalgesia (OIH) and Tolerance (clinicaltrials.gov) - P4 | N=200 | Terminated | Sponsor: Massachusetts General Hospital | Active, not recruiting ➔ Terminated; End of NIH funding

Trial termination • Pain

An Alternative Procedural Approach to Treating Calcific Tendinitis of the Hip (ASA 2025) - "Two 2x2mm bony fragments were removed, and the patient reported 90% pain relief after the procedure. This case highlights an effective alternative technique for treating calcific tendinitis when standard procedures like Tenex are unavailable."

Musculoskeletal Diseases • Orthopedics

Chronic Morel-Lavallée Lesion Treated With Percutaneous Ultrasonic Debridement. (PubMed, J Clin Ultrasound) - "This case describes the successful use of this technology in a 68-year-old female with a 10-year history of a Morel-Lavallée lesion. Treatment of Morel-Lavallée lesions using the Tenex device is a feasible, minimally invasive alternative to conventional surgery."

Journal • Musculoskeletal Diseases • Pain

Authors' response to the letter to the editor on "Tendon modification with percutaneous ultrasound-guided tenotomy using TENEX®: A histological and macroscopic analysis of a bovine cadaveric model.". (PubMed, Interv Pain Med) - No abstract available

Journal

Percutaneous Tenotomy With Ultrasonic Debridement for Lateral Epicondylitis: Surgical Technique and Short-term Patient Outcomes. (PubMed, Tech Hand Up Extrem Surg) - "This study evaluates the efficacy of percutaneous ultrasonic tenotomy (PUT) with the Tenex TX system as a minimally invasive alternative for treating chronic lateral epicondylitis...Its minimally invasive nature, coupled with rapid recovery and high patient satisfaction, underscores its potential to replace more invasive surgical alternatives. However, further research with larger cohorts and extended follow-ups is warranted to validate long-term outcomes and refine procedural protocols."

Journal • Anesthesia • Musculoskeletal Diseases • Musculoskeletal Pain • Pain

Diagnosis and Minimally Invasive Surgical Treatment for Enhancing Intrathecal/Intrasynovial Tendon Injuries. (PubMed, Vet Clin North Am Equine Pract) - "In these cases, endoscopic evaluation and debridement, not only of the lesion, but also any other secondary injury present, can enhance the healing of the tendon or ligament and improve the athletic prognosis. Careful planning of the approach, positioning, instrumentation, and thorough knowledge of the anatomy are vital features that can enhance a successful outcome."

Journal • Review

Tendon modification with percutaneous Ultrasound-Guided Tenotomy using TENEX®: A histological and macroscopic analysis of a bovine cadaveric model. (PubMed, Interv Pain Med) - "Tukey's Honest Significant Difference (HSD) test revealed significant differences between most groups (p < 0.001), except between the 3-min and 5-min treatments, which showed no significant difference (p = 0.969). PUTT induces significant structural changes in the paratenon and fascicle layer with longer treatment duration, resulting in more pronounced modifications."

Journal • Pain

Minimally invasive ultrasound-guided percutaneous plantar fasciotomy on chronic plantar fasciitis: A retrospective analysis. (PubMed, Foot Ankle Surg) - "MIS ultrasound-guided plantar fasciotomy appears to be a reliable surgical treatment option for chronic plantar fasciitis with high patient satisfaction and safety profile."

Journal • Retrospective data • Musculoskeletal Diseases • Pain

RCT GTPS: Evaluation of TENEX for Greater Trochanteric Pain Syndrome (GTPS) (clinicaltrials.gov) - P=N/A | N=150 | Recruiting | Sponsor: Montefiore Medical Center | Not yet recruiting ➔ Recruiting

Enrollment open • Musculoskeletal Pain • Pain

A Stratified Precision Medicine Trial Targeting Selective Mechanisms of Alpha 2A Agonism as a Treatment for the Cognitive Biotype of Depression: The BIomarker Guided (BIG) Study for Depression. (PubMed, Res Sq) - "We evaluated guanfacine immediate release (GIR), an alpha 2A receptor agonist, as a novel treatment for selectively improving cognitive control circuit function and behavioral performance in a subtype of depression, the cognitive biotype...GIR significantly improved cognitive control performance, quality of life, and global life satisfaction. This study is the first to demonstrate both efficacy and target engagement of GIR as a mechanistically selective treatment specifically for the cognitive biotype of depression."

Biomarker • Journal • Alzheimer's Disease • CNS Disorders • Cognitive Disorders • Depression • Major Depressive Disorder • Mood Disorders • Psychiatry

RCT GTPS: Evaluation of TENEX for Greater Trochanteric Pain Syndrome (GTPS) (clinicaltrials.gov) - P=N/A | N=150 | Not yet recruiting | Sponsor: Montefiore Medical Center | Trial completion date: Feb 2025 ➔ Mar 2027 | Trial primary completion date: Feb 2025 ➔ Mar 2027

Trial completion date • Trial primary completion date • Musculoskeletal Pain • Pain

Randomized Controlled Trial (RCT) of Open Debridement Versus Tenex (clinicaltrials.gov) - P=N/A | N=90 | Recruiting | Sponsor: Virtua Health, Inc. | Trial completion date: Jun 2025 ➔ Jun 2026 | Trial primary completion date: Dec 2024 ➔ Dec 2025

Trial completion date • Trial primary completion date • Musculoskeletal Pain • Orthopedics

The Efficacy of Different Tenotomies in the Treatment of Lateral Epicondylitis: A Systematic Review. (PubMed, J Clin Med) - "Tenotomy is the gold standard for repair, but the research comparing the benefits of specific types of tenotomies (open, arthroscopic, percutaneous, ultrasonically assisted, and Tenex forms) is lacking...The secondary outcomes included patient-reported satisfaction, return-to-work timeframes, and procedural complications. The tenotomy outcomes were similar, regardless of the method, indicating that discussions with patients about their specific outcome preferences may help guide tenotomy method selection."

Journal • Review • Musculoskeletal Pain • Orthopedics • Pain