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Pharmacological Management of Painful Peripheral Neuropathies: A Systematic Review
INTRODUCTION: 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...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Springer Healthcare
2020
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8119529/ https://www.ncbi.nlm.nih.gov/pubmed/33145709 http://dx.doi.org/10.1007/s40122-020-00210-3 |
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author | Liampas, Andreas Rekatsina, Martina Vadalouca, Athina Paladini, Antonella Varrassi, Giustino Zis, Panagiotis |
author_facet | Liampas, Andreas Rekatsina, Martina Vadalouca, Athina Paladini, Antonella Varrassi, Giustino Zis, Panagiotis |
author_sort | Liampas, Andreas |
collection | PubMed |
description | INTRODUCTION: 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). METHODS: 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. RESULTS: 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. DISCUSSION: 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. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s40122-020-00210-3) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-8119529 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Springer Healthcare |
record_format | MEDLINE/PubMed |
spelling | pubmed-81195292021-05-14 Pharmacological Management of Painful Peripheral Neuropathies: A Systematic Review Liampas, Andreas Rekatsina, Martina Vadalouca, Athina Paladini, Antonella Varrassi, Giustino Zis, Panagiotis Pain Ther Review INTRODUCTION: 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). METHODS: 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. RESULTS: 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. DISCUSSION: 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. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s40122-020-00210-3) contains supplementary material, which is available to authorized users. Springer Healthcare 2020-11-03 2021-06 /pmc/articles/PMC8119529/ /pubmed/33145709 http://dx.doi.org/10.1007/s40122-020-00210-3 Text en © The Author(s) 2020 https://creativecommons.org/licenses/by-nc/4.0/Open Access This article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) . |
spellingShingle | Review Liampas, Andreas Rekatsina, Martina Vadalouca, Athina Paladini, Antonella Varrassi, Giustino Zis, Panagiotis Pharmacological Management of Painful Peripheral Neuropathies: A Systematic Review |
title | Pharmacological Management of Painful Peripheral Neuropathies: A Systematic Review |
title_full | Pharmacological Management of Painful Peripheral Neuropathies: A Systematic Review |
title_fullStr | Pharmacological Management of Painful Peripheral Neuropathies: A Systematic Review |
title_full_unstemmed | Pharmacological Management of Painful Peripheral Neuropathies: A Systematic Review |
title_short | Pharmacological Management of Painful Peripheral Neuropathies: A Systematic Review |
title_sort | pharmacological management of painful peripheral neuropathies: a systematic review |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8119529/ https://www.ncbi.nlm.nih.gov/pubmed/33145709 http://dx.doi.org/10.1007/s40122-020-00210-3 |
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