Neuropathic pain: a narrative review of etiology, assessment, diagnosis, and treatment for primary care providers

McCarberg, Bill; D’Arcy, Yvonne; Parsons, Bruce; Sadosky, Alesia; Thorpe, Andrew; Behar, Regina

doi:10.1080/03007995.2017.1321532

Cited by 18 publications

(19 citation statements)

References 68 publications

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“…Antidepressants and anticonvulsants are conventional treatments for neuropathic pain. The currently recommended first-line treatments are anticonvulsants such as gabapentin and pregabalin, serotonin-norepinephrine reuptake inhibitors such as duloxetine and venlafaxine, and tricyclic antidepressants [25]. Although opioids are considered a second- or third-line treatment for neuropathic pain, controversy remains over their use [5–8].…”

Section: Discussionmentioning

confidence: 99%

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Gabapentin versus Transdermal Fentanyl Matrix for the Alleviation of Chronic Neuropathic Pain of Radicular Origin: A Randomized Blind Multicentered Parallel-Group Noninferiority Trial

Hwang

Lee

Min

et al. 2019

Pain Research and Management

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A number of studies have been published proposing various approaches to the treatment of neuropathic pain; however, to our knowledge, no attempts have been made to compare gabapentin and fentanyl in patients with lumbar radiculopathy. We evaluated the relative efficacy and safety of fentanyl matrix and gabapentin for the treatment of chronic neuropathic pain of radicular origin. The study was designed as a randomized blind multicentered parallel-group noninferiority trial. A total of 108 patients with moderate-to-severe pain (≥4 intensity on an 11-point numeric rating scale) were randomly prescribed either fentanyl matrix or gabapentin over a period of 56 days. In the primary analysis, the noninferiority of fentanyl matrix treatment was evaluated in relation to the efficacy of gabapentin based on the pain intensity difference (PID) at 56 days after the first dose of the drugs. Secondary endpoints included pain relief, improvement in functional status (the Korean-Oswestry Disability Index (K-ODI)), improvement in depressive symptoms (Korean-Beck Depression Index (K-BDI)) between the 28th and 56th day, and adverse events (AEs). Analysis of the primary efficacy endpoint established the noninferiority of fentanyl matrix compared with gabapentin, with no statistically significant difference observed in the PID after 56 days for the two treatment groups. Similarly, analysis of pain relief revealed no significant differences between the groups on days 28 and 56. There was no difference in the K-ODI and K-BDI between the groups during the study period. The overall incidence of at least one AE was similar for fentanyl matrix (67.3%) and gabapentin (69.6%). The most commonly reported AEs for patients treated with fentanyl matrix and gabapentin included dizziness (30.8% vs. 44.6%, respectively), somnolence (26.9% vs. 35.7%), and constipation (15.4% vs. 17.9%). This study demonstrated that the analgesic effect of fentanyl matrix is noninferior in comparison with gabapentin and supports the use of fentanyl matrix as an effective and safe treatment for moderate-to-severe chronic neuropathic pain. This trial is registered with NCT01127100.

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Section: Discussionmentioning

confidence: 99%

“…The efficacy of gabapentin in relieving neuropathic pain has been proven in many studies and is recommended as a first-line treatment [22, 23, 25]. Because of this, our study was designed as a noninferiority trial.…”

Section: Discussionmentioning

confidence: 99%

Gabapentin versus Transdermal Fentanyl Matrix for the Alleviation of Chronic Neuropathic Pain of Radicular Origin: A Randomized Blind Multicentered Parallel-Group Noninferiority Trial

Hwang

Lee

Min

et al. 2019

Pain Research and Management

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“…The neuropathic disease is common in cancer survivors and may result from the infiltration of nerve tissue by the tumor, radiation treatment, chemotherapy, or cancer-related surgery, leading to symptoms such as pain and functional impairment (59). Schönsteiner et al, 2017 (38) have demonstrated the beneficial impact (symptoms relieve, physical fitness and sensory function) on chemotherapy-induced polyneuropathy (CIPN) of a program including massage, mobilization as well as physical exercises and WBV.…”

Section: Discussionmentioning

confidence: 99%

Whole body vibration exercise in the management of cancer therapy-related morbidities: A systematic review

Lopes-Souza

Dionello

Sá-Caputo

et al. 2018

DD&T

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The purpose of this systematic review was to investigate the effects of whole body vibration (WBV) exercise in the management of cancer therapy-related morbidities. The PubMED and PEDro databases were used to access publications published in English about the use of whole body vibration (WBV) exercises in cancer patients until February 22 2017. The studies included were classified according to the level of evidence (LE) by the National Health and Medical Research Council Hierarchy of evidence and the methodological quality (MQ) by the PEDro scale. The four included studies (2 of them with "high" LE-II and MQ) were performed in patients with different types of cancer (i.e. breast, lung, prostate, solid or hematological), treated with WBV exercise to counteract the cancer therapy-related morbidities. The variables evaluated were muscle activity, subjective rate of perceived exertion, exercise capacity, muscle strength, quality of life, resting urinary incontinence and severity of peripheral neuropathy. Although WBV exercise appears to be a potential treatment procedure of cancer therapy-related morbidities, further additional studies are required to determine specific and tailored protocols to be used in the different stages of the disease.

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“…Neuropathic pain is not a single disease entity but rather a complex syndrome that arises from a lesion or disease of the somatosensory system, either peripheral fibres or central neurons 1,2 . There are multiple chronic painful conditions of neuropathy including central post‐stroke pain, painful diabetic neuropathy, post‐herpetic neuralgia and peripheral nerve injury pain 2‐4 . The overall prevalence of neuropathic pain within the general population is estimated to be 7%‐10% and on an upwards trend owing to the ageing global population 2,5,6 .…”

Section: Introductionmentioning

confidence: 99%

MCRT, a multifunctional ligand of opioid and neuropeptide FF receptors, attenuates neuropathic pain in spared nerve injury model

Wang

Zhang

et al. 2021

Basic Clin Pharma Tox

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Chimeric peptide MCRT (YPFPFRTic‐NH2) was a multifunctional ligand of opioid and neuropeptide FF (NPFF) receptors and reported to be potentially antalgic in acute tail‐flick test. Here, we developed spared nerve injury (SNI) model to explore its efficacy in chronic neuropathic pain. Analgesic tolerance, opioid‐induced hyperalgesia and gastrointestinal transit were measured for safety evaluation. Intracerebroventricular (i.c.v.) and intraplantar (i.pl.) injections were conducted as central and peripheral routes, respectively. Results demonstrated that MCRT alleviated neuropathic pain effectively and efficiently, with the ED50 values of 4.93 nmol/kg at the central level and 3.11 nmol/kg at the peripheral level. The antagonist blocking study verified the involvement of mu‐, delta‐opioid and NPFF receptors in MCRT produced anti‐allodynia. Moreover, the separation of analgesia from unwanted effects was preliminarily achieved and that MCRT caused neither analgesic tolerance nor hyperalgesia after chronic i.c.v. administration, nor constipation after i.pl. administration. Notably, the local efficacy of MCRT in SNI mice was about one thousandfold higher than morphine and ten thousandfold higher than pregabalin, indicating a great promise in the future treatment of neuropathic pain.

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Neuropathic pain: a narrative review of etiology, assessment, diagnosis, and treatment for primary care providers

Cited by 18 publications

References 68 publications

Gabapentin versus Transdermal Fentanyl Matrix for the Alleviation of Chronic Neuropathic Pain of Radicular Origin: A Randomized Blind Multicentered Parallel-Group Noninferiority Trial

Gabapentin versus Transdermal Fentanyl Matrix for the Alleviation of Chronic Neuropathic Pain of Radicular Origin: A Randomized Blind Multicentered Parallel-Group Noninferiority Trial

Whole body vibration exercise in the management of cancer therapy-related morbidities: A systematic review

MCRT, a multifunctional ligand of opioid and neuropeptide FF receptors, attenuates neuropathic pain in spared nerve injury model

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