Drugs Effective on Diabetic Peripheral Neuropathy-Related Pain

Researchers conducted a systematic literature review to evaluate the effect of pharmacologic treatments of diabetic peripheral neuropathy on pain and quality of life.

Several classes of drugs reduce neuropathy-related pain better than placebo, according to a review recently published in Neurology.¹

Julie M. Waldfogel, PharmD, from the Johns Hopkins Hospital in Baltimore, and colleagues conducted a systematic literature review to evaluate the effect of pharmacologic treatments of diabetic peripheral neuropathy (DPN) on pain and quality of life.

The researchers identified an additional 24 published studies and 25 unpublished studies, since the last completed systematic review of 57 eligible studies. Compared to placebo, the serotonin-norepinephrine reuptake inhibitors duloxetine and venlafaxine (moderate strength of evidence [SOE]), the anticonvulsants pregabalin and oxcarbazepine (low SOE), the drug classes tricyclic antidepressants (low SOE) and atypical opioids (low SOE), and botulinum toxin (low SOE) were more effective for reducing neuropathy-related pain. Incomplete reporting prevented conclusions about quality of life. All evaluated studies were short-term (less than 6 months), and for all effective drugs, adverse effects caused >9% dropout rates.

“Future studies should evaluate longer-term outcomes, use methods, and measures recommended by pain organizations, and assess patients’ quality of life,” the authors write.

Reference

Waldfogel JM, Nesbit SA, Dy SM, et al. Pharmacotherapy for diabetic peripheral neuropathy pain and quality of life: A systematic review. Neurology. 2017