Drug therapy for chronic idiopathic axonal polyneuropathy

Abstract

Cochrane Database of Systematic Reviews Data collection and analysis Two review authors independently reviewed the results of the literature search and extracted details of trial methodology and outcome data of all potentially relevant trials. Main results We identified 39 studies and assessed them for possible inclusion in the review, but we excluded all of them because of insu icient quality or lack of relevance. We summarised evidence from non-randomised studies in the Discussion. Authors' conclusions Even though CIAP has been clearly described and delineated, no adequate randomised or quasi-randomised controlled clinical treatment trials have been performed. In their absence there is no proven e icacious drug therapy.

A secondary analysis of PAIN‐CONTRoLS: Pain's impact on sleep, fatigue, and activities of daily living

“…The lack of trials is an opportunity for further research to define efficacious therapies. 25 Limitations of this study include that it was open-label and lacked a placebo-control. Since a per-protocol analysis was performed, only patients that completed the study submitted survey data.…”

A secondary analysis of PAIN‐CONTRoLS: Pain's impact on sleep, fatigue, and activities of daily living

“…The lack of trials is an opportunity for further research to define efficacious therapies. 25 Limitations of this study include that it was open-label and lacked a placebo-control. Since a per-protocol analysis was performed, only patients that completed the study submitted survey data.…”

Pain, sleep, fatigue, and activities of daily living in patients with neuropathy

“…Furthermore, CSPN‐associated pain affects sleep and activities of daily living, and can worsen fatigue 3,4 . Given these challenges with CSPN, it is clear that there is an important need to help these patients, but quality studies are lacking 5 . Many of the medications we use to treat neuropathic symptoms are borrowed from other disease treatments, meaning they are not specifically developed for CSPN, and frequently have unpleasant side effects.…”

“…3,4 Given these challenges with CSPN, it is clear that there is an important need to help these patients, but quality studies are lacking. 5 Many of the medications we use to treat neuropathic symptoms are borrowed from other disease treatments, meaning they are not specifically developed for CSPN, and frequently have unpleasant side effects. Furthermore, although the underlying causes of CSPN are likely heterogeneous, the pain mechanism is assumed to be similar.…”

Enriched enrollment randomized double-blind placebo-controlled cross-over trial with phenytoin cream in painful chronic idiopathic axonal polyneuropathy (EPHENE): a study protocol

“…Chronic idiopathic axonal polyneuropathy (CIAP) is a slowly progressive distal symmetric sensory or sensorimotor polyneuropathy without a known cause [ 1 ]. Sensory or sensorimotor symptoms start in the toes and gradually extend to the feet or lower legs, and sometimes involve the hands.…”

“…Painful positive sensory symptoms include tingling, pins and needles, burning. Up till now, no randomized controlled trials have been conducted in patients suffering from (painful) CIAP [ 1 ]. However, current first-line pharmacological treatment recommendations for painful polyneuropathy in general are oral tricyclic antidepressants, serotonin-noradrenaline reuptake inhibitors, and gabapentinoids [ 6 – 9 ].…”

A secondary analysis of PAIN‐CONTRoLS: Pain's impact on sleep, fatigue, and activities of daily living

“…The lack of trials is an opportunity for further research to define efficacious therapies. 25 Limitations of this study include that it was open-label and lacked a placebo-control. Since a per-protocol analysis was performed, only patients that completed the study submitted survey data.…”

Pain, sleep, fatigue, and activities of daily living in patients with neuropathy

“…Furthermore, CSPN‐associated pain affects sleep and activities of daily living, and can worsen fatigue 3,4 . Given these challenges with CSPN, it is clear that there is an important need to help these patients, but quality studies are lacking 5 . Many of the medications we use to treat neuropathic symptoms are borrowed from other disease treatments, meaning they are not specifically developed for CSPN, and frequently have unpleasant side effects.…”

“…3,4 Given these challenges with CSPN, it is clear that there is an important need to help these patients, but quality studies are lacking. 5 Many of the medications we use to treat neuropathic symptoms are borrowed from other disease treatments, meaning they are not specifically developed for CSPN, and frequently have unpleasant side effects. Furthermore, although the underlying causes of CSPN are likely heterogeneous, the pain mechanism is assumed to be similar.…”

Enriched enrollment randomized double-blind placebo-controlled cross-over trial with phenytoin cream in painful chronic idiopathic axonal polyneuropathy (EPHENE): a study protocol

“…Chronic idiopathic axonal polyneuropathy (CIAP) is a slowly progressive distal symmetric sensory or sensorimotor polyneuropathy without a known cause [ 1 ]. Sensory or sensorimotor symptoms start in the toes and gradually extend to the feet or lower legs, and sometimes involve the hands.…”

“…Painful positive sensory symptoms include tingling, pins and needles, burning. Up till now, no randomized controlled trials have been conducted in patients suffering from (painful) CIAP [ 1 ]. However, current first-line pharmacological treatment recommendations for painful polyneuropathy in general are oral tricyclic antidepressants, serotonin-noradrenaline reuptake inhibitors, and gabapentinoids [ 6 – 9 ].…”

A secondary analysis of PAIN‐CONTRoLS: Pain's impact on sleep, fatigue, and activities of daily living

“…The lack of trials is an opportunity for further research to define efficacious therapies. 25 Limitations of this study include that it was open-label and lacked a placebo-control. Since a per-protocol analysis was performed, only patients that completed the study submitted survey data.…”

Pain, sleep, fatigue, and activities of daily living in patients with neuropathy

“…Furthermore, CSPN‐associated pain affects sleep and activities of daily living, and can worsen fatigue 3,4 . Given these challenges with CSPN, it is clear that there is an important need to help these patients, but quality studies are lacking 5 . Many of the medications we use to treat neuropathic symptoms are borrowed from other disease treatments, meaning they are not specifically developed for CSPN, and frequently have unpleasant side effects.…”

“…3,4 Given these challenges with CSPN, it is clear that there is an important need to help these patients, but quality studies are lacking. 5 Many of the medications we use to treat neuropathic symptoms are borrowed from other disease treatments, meaning they are not specifically developed for CSPN, and frequently have unpleasant side effects. Furthermore, although the underlying causes of CSPN are likely heterogeneous, the pain mechanism is assumed to be similar.…”

Enriched enrollment randomized double-blind placebo-controlled cross-over trial with phenytoin cream in painful chronic idiopathic axonal polyneuropathy (EPHENE): a study protocol

“…Chronic idiopathic axonal polyneuropathy (CIAP) is a slowly progressive distal symmetric sensory or sensorimotor polyneuropathy without a known cause [ 1 ]. Sensory or sensorimotor symptoms start in the toes and gradually extend to the feet or lower legs, and sometimes involve the hands.…”

“…Painful positive sensory symptoms include tingling, pins and needles, burning. Up till now, no randomized controlled trials have been conducted in patients suffering from (painful) CIAP [ 1 ]. However, current first-line pharmacological treatment recommendations for painful polyneuropathy in general are oral tricyclic antidepressants, serotonin-noradrenaline reuptake inhibitors, and gabapentinoids [ 6 – 9 ].…”