A systematic review of treatment of Painful Diabetic Neuropathy by Pain Phenotype versus treatment Based on Medical comorbidities

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dc.citation.volume8]
dc.contributor.authorRolim, Luiz Clemente [UNIFESP]
dc.contributor.authorKoga da Silva, Edina M. [UNIFESP]
dc.contributor.authorDe Sa, Joao Roberto [UNIFESP]
dc.contributor.authorDib, Sergio Atala [UNIFESP]
dc.coverageLausanne
dc.date.accessioned2020-06-26T16:30:35Z
dc.date.available2020-06-26T16:30:35Z
dc.date.issued2017
dc.description.abstractBackground: Painful diabetic neuropathy (PDN) is a serious, polymorphic, and prevalent complication of diabetes mellitus. Most PDN treatment guidelines recommend a selection of drugs based on patient comorbidities. Despite the large numbers of medications available, most randomized clinical trials (RCTs) conducted so far have yielded unsatisfactory outcomes. Therefore, treatment may require a personalized approach based on pain phenotype or comorbidities. Methods: To evaluate whether or not a patient's pain phenotype or comorbidities can influence the response to a specific PDN treatment, we conducted a systematic review using two different approaches: pain phenotype and associated comorbidities-based treatment. Results: Out of 45 identified papers, 7 were thoroughly reviewed. We found four RCTs stratified according to pain phenotype with three main results: (1) paroxysmal pain had a better response to pregabalinen
dc.description.abstract(2) the preservation of thermal sensation or nociception anticipated a positive response to the topical treatment of painen
dc.description.abstractand, (3) after a failure to duloxetine (60 mg/day), the patients with evoked pain or severe deep pain had a better response to association of duloxetine/pregabalin while those with paresthesia/dysesthesia benefited from duloxetine monotherapy (120 mg/day). By contrast, the other three papers provided weak and even contradictory evidence about PDN treatment based on comorbidities. Conclusion: Although more studies are needed to provide an adequate recommendation for clinical practice, our systematic review has provided some evidence that PDN phenotyping may optimize clinical outcomes and could, in the future, lead to both less empirical medicine and more personalized pain therapeutics.en
dc.description.affiliationUniv Fed Sao Paulo UNIFESP, Diabet Ctr, Endocrinol Div, Escola Paulista Med, Sao Paulo, Brazil
dc.description.affiliationUniv Fed Sao Paulo UNIFESP, Brazilian Cochrane Ctr, Escola Paulista Med, Sao Paulo, Brazil
dc.description.affiliationUnifespUniv Fed Sao Paulo UNIFESP, Diabet Ctr, Endocrinol Div, Escola Paulista Med, Sao Paulo, Brazil
dc.description.affiliationUnifespUniv Fed Sao Paulo UNIFESP, Brazilian Cochrane Ctr, Escola Paulista Med, Sao Paulo, Brazil
dc.description.sourceWeb of Science
dc.format.extent-
dc.identifierhttp://dx.doi.org/10.3389/fneur.2017.00285]
dc.identifier.citationFrontiers In Neurology. Lausanne, v. 8, p. -, 2017.
dc.identifier.doi10.3389/fneur.2017.00285
dc.identifier.fileWOS000403716600001.pdf
dc.identifier.issn1664-2295
dc.identifier.urihttps://repositorio.unifesp.br/handle/11600/53646
dc.identifier.wosWOS:000403716600001
dc.language.isoeng
dc.publisherFrontiers Media Sa
dc.relation.ispartofFrontiers In Neurology
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectcomorbidityen
dc.subjectchronic neuropathic painen
dc.subjectdiabetes mellitusen
dc.subjectpainful diabetic neuropathyen
dc.subjectpain phenotypeen
dc.subjectrandomized clinical trialen
dc.subjectsystematic reviewen
dc.titleA systematic review of treatment of Painful Diabetic Neuropathy by Pain Phenotype versus treatment Based on Medical comorbiditiesen
dc.typeinfo:eu-repo/semantics/article
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