The evidence for pharmacological treatment of neuropathic pain

By N. Finnerup, S. Sindrup, T. S. Jensen. Pain, 2010

1,027 citations recorded by the source corpus.

&NA; Randomized, double‐blind, placebo‐controlled trials on neuropathic pain treatment are accumulating, so an updated review of the available evidence is needed. Studies were identified using MEDLINE and EMBASE searches. Numbers needed to treat (NNT) and numbers needed to harm (NNH) values were used to compare the efficacy and safety of different treatments for a number of neuropathic pain conditions. One hundred and seventy‐four studies were included, representing a 66% increase in published randomized, placebo‐controlled trials in the last 5 years. Painful poly‐neuropathy (most often due to diabetes) was examined in 69 studies, postherpetic neuralgia in 23, while peripheral nerve injury, central pain, HIV neuropathy, and trigeminal neuralgia were less often studied. Tricyclic antidepressants, serotonin noradrenaline reuptake inhibitors, the anticonvulsants gabapentin and pregabalin, and opioids are the drug classes for which there is the best evidence for a clinical relevant effect. Despite a 66% increase in published trials only a limited improvement of neuropathic pain treatment has been obtained. A large proportion of neuropathic pain patients are left with insufficient pain relief. This fact calls for other treatment options to target chronic neuropathic pain. Large‐scale drug trials that aim to identify possible subgroups of patients who are likely to respond to specific drugs are needed to test the hypothesis that a mechanism‐based classification may help improve treatment of the individual patients.

Subfields: Anesthesiology and Pain Medicine, Neurology, Physiology

View Paper: https://www.semanticscholar.org/paper/afce89e37f158b0345cc01c0c65532d1a7c1c3ca

How researchers see this paper

The researchers whose trusted networks rank it highest, strongest advocate first. Every researcher gets a different order.

In Anesthesiology and Pain Medicine

1. Christian A. von Hehn
2. F. Porreca
3. Kozo Morimura
4. R. Baron
5. Clifford J. Woolf
6. M. Ossipov

In Neurology

1. Clifford J. Woolf
2. Christian A. von Hehn
3. F. Porreca
4. Kozo Morimura
5. R. Baron
6. M. Ossipov

In Physiology

1. Clifford J. Woolf
2. R. Baron
3. Christian A. von Hehn
4. F. Porreca
5. Kozo Morimura
6. M. Ossipov
7. R. Ji
8. Arne May

Citations in the corpus

• Descending pain modulation and chronification of pain (2014, positive): “In spite of its prevalence and impact on patients’ lives and on society, chronic pain is still poorly managed and current therapies provide inadequate relief [35,36].”
• Deconstructing the Neuropathic Pain Phenotype to Reveal Neural Mechanisms (2012, positive): “As typically only 30% of patients respond to even the gold standard FDA approved treatments (Finnerup et al., 2010), identification of the pattern of mechanisms present in an individual should be a useful approach for identifying patients more likely to respond to a particular treatment and establis”