Study Compares Treatment Options for Diabetic Peripheral Neuropathy

In a recent study which systematically assessed the effectiveness of pharmacologic treatments for diabetic peripheral neuropathy (DPN), researchers found that duloxetine and venlafaxine, pregabalin and oxcarbazepine, tricyclic antidepressants, atypical opioids, and botulinum toxin were more effective than placebo at reducing pain, although quality of life was underreported.

For their analysis, the researchers updated a recently completed systematic review of 57 studies with an additional 24 published and 25 unpublished studies of various DPN medications.
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Overall, duloxetine and venlafaxine, pregabalin and oxcarbazepine, tricyclic antidepressants and atypical opioids, and botulinum toxin were more effective than placebo at reducing pain associated with DPN.

The researchers were unable to draw any conclusions about the drugs’ effects on quality of life, due to incomplete reporting. Further, all effective drugs had more than 9% dropouts from adverse effects, and all studies were of less than 6 months duration.

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

—Michael Potts

Reference:

Waldfogel JM, Nesbit SA, Dy SM, et al. Pharmacotherapy for diabetic peripheral neuropathy pain and quality of life [published online March 24, 2017]. doi: http:/​/​dx.​doi.​org/​10.​1212/​WNL.​0000000000003882.