• Fang Yang, Qiang Lin, Lihua Dong, Xiaohui Gao, and Su'e Zhang.
• Departments of Neurology.
• Clin J Pain. 2018 Jul 1; 34 (7): 685-690.

ObjectivesTrigeminal neuralgia (TN) is commonly seen in older persons and negatively influences their daily life. Although some research on the efficacy of TN drugs has been conducted, the optimal choice still remains uncertain. Therefore, this network meta-analysis (NMA) evaluated the efficacy and performance of 8 drugs with respect to TN.MethodsAll literature was retrieved from the PubMed and Embase electronic databases by jointly searching key terms. The only outcome was response rate, expressed as the odds ratio with 95% credible/confidence intervals. Both a pairwise meta-analysis and NMA were conducted. Heat plot and node splitting were computed to measure the consistency between direct and indirect evidence. In addition, surface under cumulative ranking curves were utilized to rank different drugs for treating TN.ResultsIn total, 13 studies and 672 TN patients were included in this NMA. With regard to the primary endpoint response rate, only lidocaine (LDC), botulinum toxin type A (BTX-A), and carbamazepine (CBZ) had a statistical better performance than the placebo. According to the surface under cumulative ranking curves, LDC, BTX-A, and CBZ are the most effective drugs for treating patients with TN.ConclusionsAmong the 8 drugs investigated, all exhibited a capacity to alleviate TN more than the placebo except for pimozide and proparacaine. Moreover, LDC, BTX-A, and CBZ stood out for their high efficacy and could be recommended as the primary choice of treatment for TN.

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