OBJECTIVE: To estimate the relative efficacy of pharmacological therapies for the treatment of postherpetic neuralgia (PHN), multiple sclerosis (MS)-related pain, posttraumatic pain, central poststroke pain (CPSP) and human immunodeficiency virus (HIV)-related neuropathic pain (NeP). METHODS: This systematic review (through June 2011) identified randomised, controlled trials of treatments for these conditions. Bayesian mixed treatment comparison (MTC) methods were used to determine the relative efficacy and safety among the treatments within each pain condition. RESULTS: Fifty studies were identified: 33 PHN, 2 MS-related pain, 3 CPSP, 3 posttraumatic pain and 9 HIV-related NeP. Data from 28 PHN studies including 21 interventions and 4317 patients were included into the PHN MTC. Of treatments studied in ≥ 50 patients, opioids had the greatest mean pain reduction of -1.70 vs. placebo on an 11-point numeric rating scale. Pregabalin ≥ 300 mg/day was most effective for ≥ 30% and ≥ 50% pain reduction [relative risk (RR) vs. placebo = 2.44 and 2.13, respectively]. Data identified for MS-related pain, CPSP, posttraumatic pain and HIV-related NeP were sparse; only 7 of 17 studies had ≥ 50 patients. Adverse events (AEs) and discontinuations for most treatments were not significantly greater than placebo except in PHN, where 8 of 12 treatments had higher risks of AEs compared with placebo and tricyclic antidepressants and opioids had higher risk of discontinuation compared with placebo. CONCLUSIONS: Guideline-recommended treatments for PHN were more effective than placebo on the pain NRS and for ≥ 30% and ≥ 50% pain reduction. Although guidelines exist for the management of less common NeP conditions, little published evidence supports them. These results highlight the need for additional evaluations and more complete reporting of outcomes to help guide physicians' treatment selections.
OBJECTIVE: To estimate the relative efficacy of pharmacological therapies for the treatment of postherpetic neuralgia (PHN), multiple sclerosis (MS)-related pain, posttraumatic pain, central poststroke pain (CPSP) and human immunodeficiency virus (HIV)-related neuropathic pain (NeP). METHODS: This systematic review (through June 2011) identified randomised, controlled trials of treatments for these conditions. Bayesian mixed treatment comparison (MTC) methods were used to determine the relative efficacy and safety among the treatments within each pain condition. RESULTS: Fifty studies were identified: 33 PHN, 2 MS-related pain, 3 CPSP, 3 posttraumatic pain and 9 HIV-related NeP. Data from 28 PHN studies including 21 interventions and 4317 patients were included into the PHN MTC. Of treatments studied in ≥ 50 patients, opioids had the greatest mean pain reduction of -1.70 vs. placebo on an 11-point numeric rating scale. Pregabalin ≥ 300 mg/day was most effective for ≥ 30% and ≥ 50% pain reduction [relative risk (RR) vs. placebo = 2.44 and 2.13, respectively]. Data identified for MS-related pain, CPSP, posttraumatic pain and HIV-related NeP were sparse; only 7 of 17 studies had ≥ 50 patients. Adverse events (AEs) and discontinuations for most treatments were not significantly greater than placebo except in PHN, where 8 of 12 treatments had higher risks of AEs compared with placebo and tricyclic antidepressants and opioids had higher risk of discontinuation compared with placebo. CONCLUSIONS: Guideline-recommended treatments for PHN were more effective than placebo on the pain NRS and for ≥ 30% and ≥ 50% pain reduction. Although guidelines exist for the management of less common NeP conditions, little published evidence supports them. These results highlight the need for additional evaluations and more complete reporting of outcomes to help guide physicians' treatment selections.
Authors: Song Cao; Bangyong Qin; Yi Zhang; Jie Yuan; Bao Fu; Peng Xie; Ganjun Song; Ying Li; Tian Yu Journal: Am J Transl Res Date: 2018-01-15 Impact factor: 4.060
Authors: Walter Kostich; Brian D Hamman; Yu-Wen Li; Sreenivasulu Naidu; Kumaran Dandapani; Jianlin Feng; Amy Easton; Clotilde Bourin; Kevin Baker; Jason Allen; Katerina Savelieva; Justin V Louis; Manoj Dokania; Saravanan Elavazhagan; Pradeep Vattikundala; Vivek Sharma; Manish Lal Das; Ganesh Shankar; Anoop Kumar; Vinay K Holenarsipur; Michael Gulianello; Ted Molski; Jeffrey M Brown; Martin Lewis; Yanling Huang; Yifeng Lu; Rick Pieschl; Kevin O'Malley; Jonathan Lippy; Amr Nouraldeen; Thomas H Lanthorn; Guilan Ye; Alan Wilson; Anand Balakrishnan; Rex Denton; James E Grace; Kimberley A Lentz; Kenneth S Santone; Yingzhi Bi; Alan Main; Jon Swaffield; Ken Carson; Sandhya Mandlekar; Reeba K Vikramadithyan; Susheel J Nara; Carolyn Dzierba; Joanne Bronson; John E Macor; Robert Zaczek; Ryan Westphal; Laszlo Kiss; Linda Bristow; Charles M Conway; Brian Zambrowicz; Charles F Albright Journal: J Pharmacol Exp Ther Date: 2016-07-13 Impact factor: 4.030
Authors: Sheng-Yuan Yu; Bi-Fa Fan; Fei Yang; Marco DiBonaventura; Yu-Xuan Chen; Ruo-Yu Li; Kristen King-Concialdi; Ian Kudel; Patrick Hlavacek; Markay Hopps; Margarita Udall; Alesia Sadosky; Joseph C Cappelleri Journal: Clinicoecon Outcomes Res Date: 2019-09-03
Authors: Young-Gyun Seo; Se Hee Kim; Sang Sik Choi; Mi Kyoung Lee; Chung Hun Lee; Jung Eun Kim Journal: Medicine (Baltimore) Date: 2018-02 Impact factor: 1.889