TY - JOUR
T1 - Consensus guidelines
T2 - Treatment planning and options
AU - Argoff, Charles E.
AU - Backonja, Misha Miroslav
AU - Belgrade, Miles J.
AU - Bennett, Gary J.
AU - Clark, Michael R.
AU - Cole, B. Eliot
AU - Fishbain, David A.
AU - Irving, Gordon A.
AU - McCarberg, Bill H.
AU - McLean, Michael J.
PY - 2006/4
Y1 - 2006/4
N2 - Despite the number of patients affected by diabetic peripheral neuropathic pain (DPNP), little consensus exists about the pathophysiology, best diagnostic tools, and primary treatment choices. Theories about tlie causes of DPNP are Inextricably linked with the causes of dietetic neuropathies, yet most patients with such neuropathies do not experience pain. The factors that differentiate patients with pain from those without remain unknown and are the subject of much research. When choosing treatment for patients with DPNP, physicians are confronted with a myriad of choices, none of which has been shown to be effective for all patients. This article reviews the evidence for these treatments and attempts to guide physicians in choosing those treatments based on evidence from well-designed clinical trials to support their use. Two agents, duioxetine and pregabalin, are formally approved by the Food and Drug Administration for the treatment of DPNIP. Dn addition, several other agents, Including the tricyclic class of antidepressants, have been effective in clinical trials. Ultimately, treatment choice must also Include consideration of adverse effects, individual patient factors such as comorbidities, and often cost.
AB - Despite the number of patients affected by diabetic peripheral neuropathic pain (DPNP), little consensus exists about the pathophysiology, best diagnostic tools, and primary treatment choices. Theories about tlie causes of DPNP are Inextricably linked with the causes of dietetic neuropathies, yet most patients with such neuropathies do not experience pain. The factors that differentiate patients with pain from those without remain unknown and are the subject of much research. When choosing treatment for patients with DPNP, physicians are confronted with a myriad of choices, none of which has been shown to be effective for all patients. This article reviews the evidence for these treatments and attempts to guide physicians in choosing those treatments based on evidence from well-designed clinical trials to support their use. Two agents, duioxetine and pregabalin, are formally approved by the Food and Drug Administration for the treatment of DPNIP. Dn addition, several other agents, Including the tricyclic class of antidepressants, have been effective in clinical trials. Ultimately, treatment choice must also Include consideration of adverse effects, individual patient factors such as comorbidities, and often cost.
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U2 - 10.1016/S0025-6196(11)61475-4
DO - 10.1016/S0025-6196(11)61475-4
M3 - Article
C2 - 16608049
AN - SCOPUS:33645689140
VL - 81
SP - S12-S25
JO - Mayo Clinic Proceedings
JF - Mayo Clinic Proceedings
SN - 0025-6196
IS - 4 SUPPL.
ER -