EFNS guidelines on the pharmacological treatment of neuropathic pain: 2010 revision

来自 EBSCO

喜欢 0

阅读量：

256

作者：

N Attal，G Cruccu，R Baron，Haanp M，P Hansson，TS Jensen，T Nurmikko，European Federation of Neurological Societies

展开

摘要：

Background and objectives: This second European Federation of Neurological Societies Task Force aimed at updating the existing evidence about the pharmacological treatment of neuropathic pain since 2005.Methods: Studies were identified using the Cochrane Database and Medline. Trials were classified according to the aetiological condition. All class I and II randomized controlled trials (RCTs) were assessed; lower class studies were considered only in conditions that had no top-level studies. Treatments administered using repeated or single administrations were considered, provided they are feasible in an outpatient setting.Results: Most large RCTs included patients with diabetic polyneuropathies and post-herpetic neuralgia, while an increasing number of smaller studies explored other conditions. Drugs generally have similar efficacy in various conditions, except in trigeminal neuralgia, chronic radiculopathy and HIV neuropathy, with level A evidence in support of tricyclic antidepressants (TCA), pregabalin, gabapentin, tramadol and opioids (in various conditions), duloxetine, venlafaxine, topical lidocaine and capsaicin patches (in restricted conditions). Combination therapy appears useful for TCA-gabapentin and gabapentin-opioids (level A).Conclusions: There are still too few large-scale comparative studies. For future trials, we recommend to assess comorbidities, quality of life, symptoms and signs with standardized tools and attempt to better define responder profiles to specific drug treatments.

展开

关键词：

neuropathic pain painful diabetic polyneuropathy post‐herpetic neuralgia trigeminal neuralgia central neuropathic pain evidence‐based recommendations pharmacological treatment randomized clinical trials