Pharmacotherapy for diabetic peripheral neuropathy pain and quality of life

@article{Waldfogel2017PharmacotherapyFD,
  title={Pharmacotherapy for diabetic peripheral neuropathy pain and quality of life},
  author={Julie M Waldfogel and Suzanne Amato Nesbit and Sydney Morss Dy and Ritu Sharma and Allen Zhang and Lisa M Wilson and Wendy L. Bennett and Hsin-Chieh Yeh and Yohalakshmi Chelladurai and Dorianne R. Feldman and Karen A. Robinson},
  journal={Neurology},
  year={2017},
  volume={88},
  pages={1958 - 1967}
}
Objective: To systematically assess the effect of pharmacologic treatments of diabetic peripheral neuropathy (DPN) on pain and quality of life. Methods: We searched PubMed and Cochrane Database of Systematic Reviews for systematic reviews from 2011 to October 12, 2015, and PubMed, Embase, and the Cochrane Central Register of Controlled Trials for primary studies from January 1, 2013, to May 24, 2016. We searched Clinicaltrials.gov on March 9, 2016. Two reviewers independently evaluated studies… 
Different Drugs for the Treatment of Painful Diabetic Peripheral Neuropathy: A Meta-Analysis
TLDR
Pregabalin and duloxetine showed good therapeutic effects on painful DPN, but adverse events were also significant, and the analgesic effects of ABT-894 and gabapentin need to be further studied with longer and larger RCTs.
Non-pharmacologic treatments for symptoms of diabetic peripheral neuropathy: a systematic review
TLDR
Alpha-lipoic acid and spinal cord stimulation were effective for pain; studies were short-term with quality deficits and further research should address long-term outcomes and other non-pharmacologic treatments.
Reader response: Pharmacotherapy for diabetic peripheral neuropathy pain and quality of life: A systematic review
TLDR
The authors failed to find publications describing the results of 4 pregabalin studies registered on clinicaltrials.gov after searching PubMed and the Cochrane Database for systematic reviews from 2011 to October 12, 2015.
Diabetic Peripheral Neuropathy: Epidemiology, Diagnosis, and Pharmacotherapy.
TLDR
Clinical recognition of DPN is imperative for allowing timely symptom management to reduce the morbidity associated with this condition and consider potential new pharmacotherapies for painful DPN.
Longitudinal pattern of pain medication utilization in peripheral neuropathy patients
TLDR
In conclusion, opioid initiation and transition to chronic opioid therapy are frequent in a peripheral neuropathy population despite few patients receiving more than one guideline-recommended medication, and efforts to decrease opioid utilization and increase guideline- recommended medication use are needed.
Results of Mirogabalin Treatment for Diabetic Peripheral Neuropathic Pain in Asian Subjects: A Phase 2, Double-Blind, Randomized, Placebo-Controlled, Study
TLDR
Treatment was generally well tolerated; the most frequently reported TEAEs in the mirogabalin groups were somnolence and dizziness, and most AEs were mild or moderate even at the highest dose.
Current Pharmacological Treatment of Painful Diabetic Neuropathy: A Narrative Review
TLDR
The aim of this brief narrative review is to summarize the current pharmacological treatment of painful DSPN and summarizes knowledge on pathogenesis-oriented therapy, which is generally overlooked in many publications and guidelines.
Author response: Pharmacotherapy for diabetic peripheral neuropathy pain and quality of life: A systematic review
TLDR
The results of the search for each drug—including counts of studies completed without available result—can be found in table e-2.
Effectiveness of Exercise Therapy on Gait Function in Diabetic Peripheral Neuropathy Patients: A Systematic Review of Randomized Controlled Trials
TLDR
It is suggested that multi-component exercise therapy consisted of strength, ROM exercise, balance, flexibility and stretching exercises, circuit exercise training, and gait training found to enhance gait function for individuals suffering with diabetic peripheral neuropathy compared to control groups.
The potential of transdermal nitric oxide treatment for diabetic peripheral neuropathy and diabetic foot ulcers.
TLDR
The hypothesis is that a deficiency of nitric oxide synthase in diabetic patients leads to a lack of vascularization of the peripheral nerves, which causes DPN; and this could be treated with vasodilators such as nitricoxide.
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References

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TLDR
The results support a revision of the NeuPSIG recommendations for the pharmacotherapy of neuropathic pain and allow a strong recommendation for use and proposal as first-line treatment in neuropathicPain for tricyclic antidepressants, serotonin-noradrenaline reuptake inhibitors, pregabalin, and gabapentin.
Evidence-based guideline: Treatment of painful diabetic neuropathy
TLDR
A systematic review of the literature from 1960 to August 2008 found effective treatments for PDN are available, but many have side effects that limit their usefulness, and few studies have sufficient information on treatment effects on function and QOL.
Pharmacologic interventions for painful diabetic neuropathy: An umbrella systematic review and comparative effectiveness network meta-analysis.
TLDR
Three head-to-head trials showed greater pain reduction associated with serotonin-norepinephrine reuptake inhibitors (SNRIs) than anticonvulsants, and several medications may be effective for short-term management of painful diabetic neuropathy, although their comparative effectiveness is unclear.
Randomized study of tramadol/acetaminophen versus placebo in painful diabetic peripheral neuropathy
TLDR
Tramadol/APAP was more effective than placebo and was well tolerated in the management of painful DPN and was associated with significantly greater improvement than placebo.
Pregabalin for relief of neuropathic pain associated with diabetic neuropathy: A randomized, double‐blind study
TLDR
An investigation of the efficacy and safety of twice daily pregabalin enrolled 395 adults with painful DPN for ≥1 year in a 12‐week, double‐blind, placebo‐controlled trial.
Safety and efficacy of tapentadol ER in patients with painful diabetic peripheral neuropathy: results of a randomized-withdrawal, placebo-controlled trial
TLDR
Compared with placebo, tapentadol ER 100–250 mg bid provided a statistically significant difference in the maintenance of a clinically important improvement in pain12 and was well-tolerated by patients with painful DPN.
Relief of painful diabetic peripheral neuropathy with pregabalin: a randomized, placebo-controlled trial.
TLDR
Pregabalin, a new drug that interacts with the alpha2-delta protein subunit of the voltage-gated calcium channel, is an efficacious and safe treatment for the pain of this condition.
Clinical experience with desvenlafaxine in treatment of pain associated with diabetic peripheral neuropathy
TLDR
Desvenlafaxine was effective in relieving pain associated with DPN at doses of 200 and 400 mg/day, and improved activity impairment at all doses assessed, and was generally well-tolerated in the short-term and long-term studies.
Pregabalin for the treatment of painful diabetic peripheral neuropathy: a double-blind, placebo-controlled trial
TLDR
Pregabalin was safe and effective in decreasing pain associated with DPN, and also improved mood, sleep disturbance, and quality of life.
Efficacy and safety of pregabalin 600 mg/d for treating painful diabetic peripheral neuropathy: A double-blind placebo-controlled trial
TLDR
Pregabalin 600 mg/d (300 mg BID) effectively reduced pain, was well tolerated, and had no statistically significant or clinically meaningful effect on NC in patients with painful DPN.
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