Pain practice : the official journal of World Institute of Pain
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To characterize patient populations with favorable costs after the initiation of pregabalin for the treatment of painful diabetic peripheral neuropathy (pDPN) relative to duloxetine, gabapentin, and amitriptyline. ⋯ The association of lower total costs among older individuals with pDPN who maintain high adherence to pregabalin therapy relative to key comparators suggests a pharmacoeconomic advantage of pregabalin in this population combined with a need for strategies promoting adherence.
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Randomized Controlled Trial Multicenter Study
A randomized, controlled trial of gabapentin enacarbil in subjects with neuropathic pain associated with diabetic peripheral neuropathy.
Gabapentin enacarbil (GEn), a transported prodrug of gabapentin, provides sustained, dose-proportional gabapentin exposure. The purpose of this study was to investigate the dose response of GEn to select the optimal dose(s) for clinical use in subsequent diabetic peripheral neuropathy (DPN) trials. ⋯ Overall, none of the GEn treatment groups differentiated from placebo. Analyses of the secondary endpoints showed comparable results across treatment groups. However, the majority of the endpoints, including all of the pain endpoints, showed the largest numerical treatment difference was between GEn 3,600 mg and placebo. The active control, PGB (300 mg/day), did not differentiate from placebo.
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Review Comparative Study
Diagnosing neuropathic pain in patients with cancer: comparative analysis of recommendations in national guidelines from European countries.
Neuropathic pain is a prevalent symptom in patients with cancer, which needs a more specific algorithm than nociceptive pain or neuropathic pain from other origin. Clinical practice guidelines (CPGs) can be helpful in optimizing the diagnosis of neuropathic pain in patients with cancer. ⋯ This work demonstrates an important heterogeneity between European recommendations on diagnosis and assessment of neuropathic pain in patients with cancer. The main weaknesses are the low level of evidence and the absence of specific data focusing on neuropathic pain in patients with cancer. We recommend that physicians dealing with neuropathic pain in patients with cancer should be specially trained, that a specific methodology to develop CPGs should followed, and that specific research should be developed on the diagnosis of neuropathic pain in patients with cancer.
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Randomized Controlled Trial
0.025% capsaicin gel for the treatment of painful diabetic neuropathy: a randomized, double-blind, crossover, placebo-controlled trial.
Topical therapy may provide additional benefit in patients with painful diabetic neuropathy (PDN). This study was conducted to study the safety and efficacy of 0.025% capsaicin gel in this condition. ⋯ 0.025% capsaicin gel is safe and well tolerated, but does not provide significant pain relief in patients with PDN.
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Pain is a comorbid and aggravating symptom that in many conditions can be perceived differently and should therefore be managed accordingly. Numerous factors, both social and cultural, are thought to influence the analgesic prescription. However, elucidation of such areas is limited. We therefore conducted a systematic literature review to test the hypothesis that variations in provider characteristics predict the prescription of pain medication. ⋯ Our systematic review of existing literature highlights that provider's age, sex, experience, specialty, and the interplay between provider and patient characteristics are important variables in pain management. However, generalizations relating to these findings are limited by the heterogeneity of the studies and the paucity of literature in this field.