Impact of Postherpetic Neuralgia and Painful Diabetic Peripheral Neuropathy on Health Care Costs

Dworkin, Robert H.; Malone, Daniel C.; Panarites, Christopher J.; Armstrong, Edward P.; Pham, Sissi V.

doi:10.1016/j.jpain.2009.08.005

Cited by 92 publications

(79 citation statements)

References 39 publications

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“…15 -18 Painful DPN reportedly results in significantly higher healthcare costs when compared with ageand sex-matched diabetic patients without DPN. 19 Annual healthcare costs in two separate databases were 24 -38% higher even after adjusting for differences in comorbid medical conditions such as cardiovascular illness. 19 For both type 1 and type 2 diabetes, the risk of developing distal polyneuropathiesincluding painful neuropathies -appears to be inversely related to the degree of glycaemic control and is directly correlated with the duration of diabetes.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Painful Diabetic Peripheral Neuropathy among Patients with Diabetes Mellitus in the Middle East Region

Ammache²,

et al. 2011

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Section: Introductionmentioning

confidence: 99%

Prevalence of Painful Diabetic Peripheral Neuropathy among Patients with Diabetes Mellitus in the Middle East Region

Ammache²,

et al. 2011

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“…In experimental models, this is in part a result of hyperglycaemia-induced neurohormonal activation, which increases intraglomerular pressure and shear stress, leading to renal inflammation [1][2][3]. In in vitro studies of human mesangial cells, hyperglycaemia increases the mRNA expression of monocyte chemoattractant protein (MCP-1, also known as CCL2) and vascular endothelial growth factor, which have been linked to cell apoptosis, compensatory hypertrophy and hyperfiltration in animal models of diabetes mellitus [4,5]. In patients with type 1 diabetes, we have focused on the effect of acute hyperglycaemia on the urinary excretion of cytokines/chemokines rather than tissue expression of these factors, hypothesising that urinary excretion of inflammatory mediators correlates with tissue expression.…”

Section: Introductionmentioning

confidence: 99%

The effect of renal hyperfiltration on urinary inflammatory cytokines/chemokines in patients with uncomplicated type 1 diabetes mellitus

et al. 2013

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Aims/hypothesis High intraglomerular pressure causes renal inflammation in experimental models of diabetes. Our objective was to determine whether renal hyperfiltration, a surrogate for intraglomerular hypertension, is associated with increased excretion of urinary cytokines/chemokines in patients with type 1 diabetes mellitus. Methods Blood pressure, renal haemodynamic function (inulin and para-aminohippurate clearances for glomerular filtration rate (GFR) and effective renal plasma flow (ERPF), respectively) and urine samples were obtained during clamped euglycaemia in individuals with type 1 diabetes with either hyperfiltration (GFR determined using inulin [GFR INULIN ], n=28) or normofiltration (n=21) and healthy control individuals (n=18).Results Baseline clinical characteristics, dietary sodium and protein intake and blood pressure levels were similar in the diabetic and healthy control groups. In addition, HbA 1c levels were similar in the two diabetic groups. As expected baseline GFR was higher in hyperfilterers than either normofiltering diabetic patients or healthy control patients (165±9 vs 113±2 and 116±4 ml min, respectively, p< 0.01). ERPF and renal blood flow were also comparatively higher and renal vascular resistance was lower in hyperfiltering patients (p<0.01). Hyperfiltering diabetic patients had higher excretion rates for eotaxin, IFNα2, macrophagederived chemokine, platelet-derived growth factor (PDGF)-AA, PDGF-AB/BB and granulocyte-macrophage colonystimulating factor (p≤0.01). Urinary monocyte chemoattractant protein (MCP)-1 and RANTES (regulated on activation, normal T expressed and secreted) excretion was also higher in hyperfiltering vs normofiltering diabetic individuals (p<0.01) and fibroblast growth factor-2, MCP-3 and CD40K excretion was elevated in hyperfiltering diabetic individuals vs healthy controls (p<0.01). Conclusions/interpretation Renal hyperfiltration is associated with increased urinary excretion of inflammatory cytokines/chemokines in patients with uncomplicated type 1 diabetes.

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“…1 Several recent studies have shown that NP can adversely affect patients' overall health-related quality of life (HRQoL), including physical and emotional functioning, [2][3][4][5][6] and that it is associated with substantial societal costs. [6][7][8][9][10][11] Neuropathic pain is challenging to manage, and many patients have pain that is refractory to existing treatments. In randomized clinical trials (RCTs) that have examined pharmacotherapy, no more than half of patients experience clinically meaningful pain relief, which is almost always partial but not complete relief.…”

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confidence: 99%

Recommendations for the Pharmacological Management of Neuropathic Pain: An Overview and Literature Update

Dworkin

O’Connor

Audette

et al. 2010

Mayo Clinic Proceedings

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1,130

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The Neuropathic Pain Special Interest Group of the International Association for the Study of Pain recently sponsored the development of evidence-based guidelines for the pharmacological treatment of neuropathic pain. Tricyclic antidepressants, dual reuptake inhibitors of serotonin and norepinephrine, calcium channel a 2 -d ligands (ie, gabapentin and pregabalin), and topical lidocaine were recommended as first-line treatment options on the basis of the results of randomized clinical trials. Opioid analgesics and tramadol were recommended as second-line treatments that can be considered for first-line use in certain clinical circumstances. Results of several recent clinical trials have become available since the development of these guidelines. These studies have examined botulinum toxin, high-concentration capsaicin patch, lacosamide, selective serotonin reuptake inhibitors, and combination therapies in various neuropathic pain conditions. The increasing number of negative clinical trials of pharmacological treatments for neuropathic pain and ambiguities in the interpretation of these negative trials must also be considered in developing treatment guidelines. The objectives of the current article are to review the Neuropathic Pain Special Interest Group guidelines for the pharmacological management of neuropathic pain and to provide a brief overview of these recent studies.Mayo Clin Proc. 2010;85(3)(suppl):S3-S14 DPN = diabetic peripheral neuropathy; HIV = human immunodeficiency virus; HRQoL = health-related quality of life; NeuPSIG = Neuropathic Pain Special Interest Group; NP = neuropathic pain; PHN = postherpetic neuralgia; RCT = randomized clinical trial; SSNRI = selective serotonin norepinephrine reuptake inhibitor; SSRI = selective serotonin reuptake inhibitor; TCA = tricyclic antidepressant

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Impact of Postherpetic Neuralgia and Painful Diabetic Peripheral Neuropathy on Health Care Costs

Cited by 92 publications

References 39 publications

Prevalence of Painful Diabetic Peripheral Neuropathy among Patients with Diabetes Mellitus in the Middle East Region

Prevalence of Painful Diabetic Peripheral Neuropathy among Patients with Diabetes Mellitus in the Middle East Region

The effect of renal hyperfiltration on urinary inflammatory cytokines/chemokines in patients with uncomplicated type 1 diabetes mellitus

Recommendations for the Pharmacological Management of Neuropathic Pain: An Overview and Literature Update

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