More than 20 million people in the United States suffer from neuropathic pain. At least 25% of these cases are classified as unexplained and are considered latent sensory polyneuropathy (CSPN). There is no information to guide physicians’ drug choices to treat CSPN, but researchers at the University of Missouri School of Medicine and MU Healthcare have led this type of first prospective comparative efficacy study.
In this study, a large group of patients with CSPN compared four drugs with different mechanisms of action to determine the most useful drug for this condition. The study included 40 sites, enrolled 402 patients over the age of 30 diagnosed with CSPN, and reported a pain score of 4 or higher on a scale of 10.
Participants were prescribed one of four drugs commonly used to treat CSPN: nortriptyline, Tricyclic antidepressantsDuloxetine, a serotonin-norepinephrine reuptake inhibitor; pregabalin, antiepileptic drugs; or mexiletine, antiarrhythmic drugs. Patients received the prescribed treatment for 12 weeks and were evaluated at 4, 8 and 12 weeks. Participants who reported a reduction in pain of at least 50% were considered to show effective results. Patients who discontinued treatment due to side effects were also measured.
“This study went beyond whether the drug was reduced pain “We will also focus on side effects,” said Richard Barrone, MD, principal researcher and vice president of health issues at the University of Missouri. “As the first study of its kind, we compare these four drugs in a real-world environment. Provides doctors with a set of evidence to support the effective management of peripheral neuropathy and to support the need for newer and more effective drugs. Neuropathic pain.. “
Nortriptyline has the highest efficacy rate (25%), the second lowest smoking cessation rate (38%), and the highest overall usefulness. Duloxetine had the second highest efficacy rate (23%) and the lowest dropout rate (37%). Prevalence of prevalence was the lowest (15%) and smoking cessation was the highest (58%).
“There was obviously no good performance medicine “But of the four drugs, nortriptyline and duloxetine performed better when considering both efficacy and dropout. Therefore, before the other drugs tested, nortriptyline or duloxetine We recommend that you consider one of them. “
There are other non-narcotic drugs used to treat painful peripheral neuropathy, including gabapentin, venlafaxine and other sodium channel inhibitors. Barohn said doctors could build more libraries of data on the treatment of CSPN by conducting additional comparative efficacy studies on these drugs.his goal To build efficacy data for nearly 12 drugs for CSPN.
The study “Patient Advocacy Interventions for Neuropathy: Comparison of Treatments in Real Conditions (PAIN-CONTRoLS)” has recently been published. JAMA Neurology..
Richard J. Barron et al., Patient Assistance Interventions for Neuropathy: Comparison of Treatments in Real Conditions (PAIN-CONTRoLS), JAMA Neurology (2020). DOI: 10.1001 / jamaneurol.2020.2590
University of Missouri
Quote: A common type of neuropathic pain obtained from the study on October 15, 2020 from https://medicalxpress.com/news/2020-10-reveals-effective-drugs-common-neuropathic.html ( The most effective drug was revealed on October 15, 2020)
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