Therapeutic alternatives in painful diabetic neuropathy: a meta-analysis of randomized controlled trials
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Background: One of the most frequent problems caused by diabetes is the so called painful diabetic neuropathy. This condition can be treated through numerous types of therapy. The purpose of this study was to analyze, as a meta-analysis, different treatments used to alleviate painful diabetic neuropathy, with the aim of generating results that help making decisions when applying such treatments to tackle this pathology. Methods: A search was conducted in the main databases for Health Sciences, such as PUBMED, Web of Science (WOS), and IME biomedicina (Spanish Medical Reports in Biomedicine), to gather randomized controlled trials about treatments used for painful diabetic neuropathy. The analyzed studies were required to meet the inclusion criteria selected, especially those results related to pain intensity. Results: Nine randomized controlled trials were chosen. The meta-analysis shows significant positive effects for those treatments based on tapentadol [g: −1.333, 95% CI (−1.594; −1.072), P ＜ 0.05], duloxetine [g: −1.622, 95 % CI (−1.650; −1.594), P ＜ 0.05], pregabalin [g: −0.607, 95% CI (−0.980; −0.325), P ＜ 0.05], and clonidine [g: −0.242, 95 % CI (−0.543; −0.058), P ＜ 0.05]. Conclusions: This meta-analysis indicates the effectiveness of the treatments based on duloxetine, gabapentin and pregabalin, as well as other drugs, such as tapentadol and topic clonidine, whose use is better prescribed in more specific situations. The results provided can help increase the knowledge about the treatment of painful diabetic neuropathy and also in the making of clinical practice guidelines for healthcare professionals. (Korean J Pain 2018; 31: 253-60)
Abstract
Background: One of the most frequent problems caused by diabetes is the so called painful diabetic neuropathy. This condition can be treated through numerous types of therapy. The purpose of this study was to analyze, as a meta-analysis, different treatments used to alleviate painful diabetic neuropathy, with the aim of generating results that help making decisions when applying such treatments to tackle this pathology. Methods: A search was conducted in the main databases for Health Sciences, such as PUBMED, Web of Science (WOS), and IME biomedicina (Spanish Medical Reports in Biomedicine), to gather randomized controlled trials about treatments used for painful diabetic neuropathy. The analyzed studies were required to meet the inclusion criteria selected, especially those results related to pain intensity. Results: Nine randomized controlled trials were chosen. The meta-analysis shows significant positive effects for those treatments based on tapentadol [g: −1.333, 95% CI (−1.594; −1.072), P ＜ 0.05], duloxetine [g: −1.622, 95 % CI (−1.650; −1.594), P ＜ 0.05], pregabalin [g: −0.607, 95% CI (−0.980; −0.325), P ＜ 0.05], and clonidine [g: −0.242, 95 % CI (−0.543; −0.058), P ＜ 0.05]. Conclusions: This meta-analysis indicates the effectiveness of the treatments based on duloxetine, gabapentin and pregabalin, as well as other drugs, such as tapentadol and topic clonidine, whose use is better prescribed in more specific situations. The results provided can help increase the knowledge about the treatment of painful diabetic neuropathy and also in the making of clinical practice guidelines for healthcare professionals. (Korean J Pain 2018; 31: 253-60)
참고문헌 (23)
- Ogurtsova K, "IDF diabetes atlas: global estimates for the prevalence of diabetes for 2015 and 2040", Diabetes Res Clin Pract, 128, pp.40~50 (2017)[DOI]
- Asociacion Espanola de Enfermeria Vascular y Heridas (AEEVH), "Guia de practica clinica: consenso sobre ulceras vasculares y pie diabetico. Segunda edicion", pp.1~90 (2014)
- Boulton AJ, "Diabetic neuropathies: a statement by the American Diabetes Association", Diabetes Care, 28, pp.956~962 (2005)[DOI]
- Attal N, "EFNS guidelines on the pharmacological treatment of neuropathic pain: 2010 revision", Eur J Neurol, 17, pp.1113~ (2010)[DOI]
- Stein C, "Electrical stimulation and electromagnetic field use in patients with diabetic neuropathy: systematic review and meta-analysis", Braz J Phys Ther, 17, pp.93~104 (2013)[DOI]
- Schreiber AK, "Diabetic neuropathic pain: physiopathology and treatment", World J Diabetes, 6, pp.432~444 (2015)[DOI]
- Bril V, "Evidence-based guideline: treatment of painful diabetic neuropathy: report of the American academy of neurology, the American association of neuromuscular and electrodiagnostic medicine, and the American academy of physical medicine and rehabilitation", Neurology, 76, pp.1758~1765 (2011)[DOI]
- 박휴정, "Pharmacologic Management of Chronic Pain", The Korean Journal of Pain, 23(2), pp.99~108 (2010), 대한통증학회
- Moher D, "Reprint--preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement", Phys Ther, 89, pp.873~880 (2009)
- Jadad AR, "Assessing the quality of reports of randomized clinical trials: is blinding necessary?", Control Clin Trials, 17, pp.1~12 (1996)[DOI]
- Higgins JP, "The Cochrane Collaboration's tool for assessing risk of bias in randomised trials", BMJ, 343, pp.d5928~ (2011)[DOI]
- [URL]
- Goldstein DJ, "Duloxetine vs. placebo in patients with painful diabetic neuropathy", Pain, 116, pp.109~118 (2005)[DOI]
- Niesters M, "Tapentadol potentiates descending pain inhibition in chronic pain patients with diabetic polyneuropathy", Br J Anaesth, 113, pp.148~156 (2014)[DOI]
- Richter RW, "Relief of painful diabetic peripheral neuropathy with pregabalin: a randomized, placebocontrolled trial", J Pain, 6, pp.253~260 (2005)[DOI]
- Campbell CM, "Randomized control trial of topical clonidine for treatment of painful diabetic neuropathy", Pain, 153, pp.1815~1823 (2012)[DOI]
- Rauck R, "A randomized, controlled trial of gabapentin enacarbil in subjects with neuropathic pain associated with diabetic peripheral neuropathy", Pain Pract, 13, pp.485~496 (2013)[DOI]
- Weintraub MI, "Pulsed electromagnetic fields to reduce diabetic neuropathic pain and stimulate neuronal repair: a randomized controlled trial", Arch Phys Med Rehabil, 90, pp.1102~1109 (2009)[DOI]
- Weintraub MI, "Static magnetic field therapy for symptomatic diabetic neuropathy: a randomized, double-blind, placebocontrolled trial", Arch Phys Med Rehabil, 84, pp.736~746 (2003)[DOI]
- Donofrio PD, "Safety and effectiveness of topiramate for the management of painful diabetic peripheral neuropathy in an open-label extension study", Clin Ther, 27, pp.1420~1431 (2005)[DOI]
- Kulkantrakorn K, "0.025% capsaicin gel for the treatment of painful diabetic neuropathy: a randomized, double-blind, crossover, placebo-controlled trial", Pain Pract, 13, pp.497~503 (2013)[DOI]
- Neuropathic pain in adults: the pharmacological management of neuropathic pain in adults in non-specialist settings. NICE clinical guideline, "National Institute for Health and Care Excellence", National Institute for Health and Care Excellence, ~ (2013)
- Finnerup NB, "Pharmacotherapy for neuropathic pain in adults: a systematic review and meta-analysis", Lancet Neurol, 14, pp.162~173 (2015)[DOI]