Patient Assisted Intervention for Neuropathy: Comparison of Treatment in Real Life Situations (PAIN-CONTRoLS)

Barohn, Richard J.; Pasnoor, Mamatha; Brown, Alexandra R.; Herbelin, Laura; Kimminau, Kim S.; Mudaranthakam, Dinesh Pal; Jawdat, Omar; Dimachkie, Mazen M.; Iyadurai, Stanley; Stino, Amro; Kissel, John T.; Pascuzzi, Robert M.; Brannagan, Thomas H.; Wicklund, Matthew; Ahmed, Aiesha; Walk, David; Smith, George P.; Quan, Dianna; Heitzman, Darryl; López-Tóbon, Alejandro; Ladha, Shafeeq; Wolfe, Gil I.; Pulley, Michael; Hayat, Ghazala; Li, Yuebing; Thaisetthawatkul, Pariwat; Lewis, Richard A.; Biliciler, Suur; Sharma, Khema R.; Salajegheh, Kian; Trivedi, Jaya; Mallonee, William M.; Burns, Ted M.; Jacoby, Mark; Bril, Vera; Vu, Tuan; Ramchandren, Sindhu; Bazant, Mark; Austin, Sara G.; Karam, Chafic; Hussain, Yessar; Kutz, Christen; Twydell, Paul; Scelsa, Stephen N.; Kushlaf, Hani; Wymer, James P.; Hehir, Michael K.; Kolb, Noah; Ralph, Jeffrey W.; Barboi, Alexandru; Verma, Navin; Ahmed, Moiz; Memon, Anza B; Saperstein, David; Lou, Jau Shin; Swenson, Andrea; Cash, Tiyonnoh

doi:10.1001/jamaneurol.2020.2590

Cited by 29 publications

(42 citation statements)

References 38 publications

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“…A recent meta-analysis confirmed the limited efficacy of this treatment in recent randomized controlled trials (RCTs) [11]. In a Bayesian adaptive, open-label randomized clinical comparative effectiveness study, nortriptyline and duloxetine outperformed pregabalin when pain reduction and undesirable adverse effects were combined to a single end point for the treatment of chronic neuropathic pain [12]. In addition, the risk of misuse is also a major problem with pregabalin [13,14] and this drug is currently the most frequent cause of forged or falsified prescription [15].…”

Section: Pharmacological Treatmentsmentioning

confidence: 96%

French guidelines for neuropathic pain: An update and commentary

2021

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Section: Pharmacological Treatmentsmentioning

confidence: 96%

French guidelines for neuropathic pain: An update and commentary

2021

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“…One exception is the PAIN-CONTRoLS study, which compared 4 active medications for patients with cryptogenic neuropathy. 61 The study found that duloxetine and nortriptyline outperformed pregabalin and mexiletine. Comparable studies in PDN are also needed.…”

Section: Suggestions For Future Researchmentioning

confidence: 97%

Oral and Topical Treatment of Painful Diabetic Polyneuropathy: Practice Guideline Update Summary

et al. 2022

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ObjectiveTo update the 2011 American Academy of Neurology (AAN) guideline on the treatment of painful diabetic neuropathy (PDN) with a focus on topical and oral medications and medical class effects.MethodsThe authors systematically searched the literature from January 2008 to April 2020 using a structured review process to classify the evidence and develop practice recommendations using the AAN 2017 Clinical Practice Guideline Process Manual.ResultsGabapentinoids (standardized mean difference [SMD] 0.44; 95% confidence interval [CI], 0.21–0.67), serotonin-norepinephrine reuptake inhibitors (SNRIs) (SMD 0.47; 95% CI, 0.34–0.60), sodium channel blockers (SMD 0.56; 95% CI, 0.25–0.87), and SNRI/opioid dual mechanism agents (SMD 0.62; 95% CI, 0.38–0.86) all have comparable effect sizes just above or just below our cutoff for a medium effect size (SMD 0.5). Tricyclic antidepressants (TCAs) (SMD 0.95; 95% CI, 0.15–1.8) have a large effect size, but this result is tempered by a low confidence in the estimate.Recommendations SummaryClinicians should assess patients with diabetes for PDN (Level B) and those with PDN for concurrent mood and sleep disorders (Level B). In patients with PDN, clinicians should offer TCAs, SNRIs, gabapentinoids, and/or sodium channel blockers to reduce pain (Level B) and consider factors other than efficacy (Level B). Clinicians should offer patients a trial of medication from a different effective class when they do not achieve meaningful improvement or experience significant adverse effects with the initial therapeutic class (Level B) and not use opioids for the treatment of PDN (Level B).

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“…Evoked pain includes hyperalgesia (abnormally increased pain sensation to a noxious stimulus) and allodynia (pain sensation to a non-noxious stimulus), which seriously affect a patient’s quality of life, incurring extreme economic burdens [ 5 ]. Currently prescribed pain relief treatments are still unsatisfactory or have limited effectiveness [ 6 ]. Therefore, many studies have attempted to elucidate the neuropathic pain mechanism and explore novel therapies for treating neuropathic pain.…”

Section: Introductionmentioning

confidence: 99%

The Antinociceptive Potential of Camellia japonica Leaf Extract, (−)-Epicatechin, and Rutin against Chronic Constriction Injury-Induced Neuropathic Pain in Rats

2022

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Neuropathic pain is caused by a lesion or disease of the somatosensory nervous system. Currently, prescribed treatments are still unsatisfactory or have limited effectiveness. Camellia japonica leaves are known to have antioxidant and anti-inflammatory properties.; however, their antinociceptive efficacy has not yet been explored. We examined the antinociceptive efficacy and underlying mechanism of C. japonica leaf extract (CJE) in chronic constriction injury (CCI)-induced neuropathic pain models. To test the antinociceptive activity of CJE, three types of allodynia were evaluated: punctate allodynia using von Frey filaments, dynamic allodynia using a paintbrush and cotton swab, and cold allodynia using a cold plate test. CCI rats developed neuropathic pain representing increases in the three types of allodynia and spontaneous pain. In addition, CCI rats showed high phosphorylation levels of mitogen-activated protein kinases (MAPKs), transcription factors, and nociceptive mediators in dorsal root ganglion (DRG). The ionized calcium-binding adapter molecule 1 levels and neuroinflammation also increased following CCI surgery in the spinal cord. CJE and its active components have potential antinociceptive effects against CCI-induced neuropathic pain that might be mediated by MAPK activation in the DRG and microglial activation in the spinal cord. These findings suggest that CJE, (−)-epicatechin, and rutin could be novel candidates for neuropathic pain management.

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Patient Assisted Intervention for Neuropathy: Comparison of Treatment in Real Life Situations (PAIN-CONTRoLS)

Cited by 29 publications

References 38 publications

French guidelines for neuropathic pain: An update and commentary

French guidelines for neuropathic pain: An update and commentary

Oral and Topical Treatment of Painful Diabetic Polyneuropathy: Practice Guideline Update Summary

The Antinociceptive Potential of Camellia japonica Leaf Extract, (−)-Epicatechin, and Rutin against Chronic Constriction Injury-Induced Neuropathic Pain in Rats

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