| Authors |
Bril V, England JD, Franklin GM, Backonja M, Cohen JA, Del Toro DR, Feldman EL,
Iverson DJ, Perkins B, Russell JW, Zochodne DW
|
| Submitted By |
Eva Feldman on 12/10/2012 |
| Status |
Published |
| Journal |
Muscle & nerve |
| Year |
2011 |
| Date Published |
6/1/2011 |
| Volume : Pages |
43 : 910 - 917 |
| PubMed Reference |
|
| Abstract |
The objective of this report was to develop a scientifically sound and
clinically relevant evidence-based guideline for the treatment of painful
diabetic neuropathy (PDN). The basic question that was asked was: "What is the
efficacy of a given treatment (pharmacological: anticonvulsants,
antidepressants, opioids, others; non-pharmacological: electrical stimulation,
magnetic field treatment, low-intensity laser treatment, Reiki massage, others)
to reduce pain and improve physical function and quality of life (QOL) in
patients with PDN?" A systematic review of literature from 1960 to August 2008
was performed, and studies were classified according to the American Academy of
Neurology classification of evidence scheme for a therapeutic article.
Recommendations were linked to the strength of the evidence. The results
indicate that pregabalin is established as effective and should be offered for
relief of PDN (Level A). Venlafaxine, duloxetine, amitriptyline, gabapentin,
valproate, opioids (morphine sulfate, tramadol, and oxycodone
controlled-release), and capsaicin are probably effective and should be
considered for treatment of PDN (Level B). Other treatments have less robust
evidence, or the evidence is negative. Effective treatments for PDN are
available, but many have side effects that limit their usefulness. Few studies
have sufficient information on their effects on function and QOL.
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