Pharmacological Management of Painful Peripheral Neuropathies: A Systematic Review.
Management
Peripheral neuropathic pain
Pharmacological
Polyneuropathy
Journal
Pain and therapy
ISSN: 2193-8237
Titre abrégé: Pain Ther
Pays: New Zealand
ID NLM: 101634491
Informations de publication
Date de publication:
Jun 2021
Jun 2021
Historique:
received:
06
08
2020
accepted:
08
10
2020
pubmed:
5
11
2020
medline:
5
11
2020
entrez:
4
11
2020
Statut:
ppublish
Résumé
Peripheral neuropathic pain (PNP) arises either acutely or in the chronic phase of a lesion or disease of the peripheral nervous system and is associated with a notable disease burden. The management of PNP is often challenging. The aim of this systematic review was to evaluate current evidence, derived from randomized controlled trials (RCTs) that have assessed pharmacological interventions for the treatment of PNP due to polyneuropathy (PN). A systematic search of the PubMed database led to the identification of 538 papers, of which 457 were excluded due to not meeting the eligibility criteria, and two articles were identified through screening of the reference lists of the 81 eligible studies. Ultimately, 83 papers were included in this systematic review. The best available evidence for the management of painful diabetic polyneuropathy (DPN) is for amitriptyline, duloxetine, gabapentin, pregabalin and venlafaxine as monotherapies and oxycodone as add-on therapy (level II of evidence). Tramadol appears to be effective when used as a monotherapy and add-on therapy in patients with PN of various etiologies (level II of evidence). Weaker evidence (level III) is available on the effectiveness of several other agents discussed in this review for the management of PNP due to PN. Response to treatment may be affected by the underlying pathophysiological mechanisms that are involved in the pathogenesis of the PN and, therefore, it is very important to thoroughly investigate patients presenting with PNP to determine the causes of this neuropathy. Future RCTs should be conducted to shed more light on the use of pharmacological approaches in patients with other forms of PNP and to design specific treatment algorithms.
Identifiants
pubmed: 33145709
doi: 10.1007/s40122-020-00210-3
pii: 10.1007/s40122-020-00210-3
pmc: PMC8119529
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
55-68Références
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