Pharmacotherapy for neuropathic pain in adults: systematic review, meta-analysis and updated NeuPSIG recommendations
Identifieur interne : 002A20 ( Main/Exploration ); précédent : 002A19; suivant : 002A21Pharmacotherapy for neuropathic pain in adults: systematic review, meta-analysis and updated NeuPSIG recommendations
Auteurs : Nanna B. Finnerup [Danemark] ; Nadine Attal [France] ; Simon Haroutounian [États-Unis] ; Ewan Mcnicol [États-Unis] ; Ralf Baron [Allemagne] ; Robert H. Dworkin [États-Unis] ; Ian Gilron [Canada] ; Maija Haanpaa [Finlande] ; Per Hansson [Suède] ; Troels S. Jensen [Danemark] ; Peter R. Kamerman [Afrique du Sud] ; Karen Lund [Danemark] ; Andrew Moore [Royaume-Uni] ; Srinivasa N. Raja [États-Unis] ; Andrew Sc Rice [Royaume-Uni] ; Michael Rowbotham [États-Unis] ; Emily Sena [Australie] ; Philip Siddall [Australie] ; Blair H. Smith [Royaume-Uni] ; Mark Wallace [États-Unis]Source :
- The Lancet. Neurology [ 1474-4422 ] ; 2015.
Descripteurs français
- KwdFr :
- MESH :
- diagnostic : Névralgie.
- traitement médicamenteux : Névralgie.
- usage thérapeutique : Analgésiques morphiniques, Antidépresseurs tricycliques.
- Adulte, Essais contrôlés randomisés comme sujet, Gestion de la douleur, Humains.
English descriptors
- KwdEn :
- MESH :
- chemical , therapeutic use : Analgesics, Opioid, Antidepressive Agents, Tricyclic.
- diagnosis : Neuralgia.
- drug therapy : Neuralgia.
- methods : Pain Management, Randomized Controlled Trials as Topic.
- Adult, Humans.
Abstract
Neuropathic pain is difficult to treat. New treatments, clinical trials and standards of quality for assessing evidence justify an update of evidence-based recommendations for its pharmacological treatment.
The Neuropathic Pain Special Interest Group (NeuPSIG) of the International Association for the Study of Pain conducted a systematic review of randomised double-blind studies of oral and topical pharmacotherapy for neuropathic pain, including unpublished trials (retrieved from clinicaltrials.gov and pharmaceutical websites). Meta-analysis used Numbers Needed to Treat (NNT) for 50 % pain relief as primary measure and assessed publication bias. Recommendations used the Grading of Recommendations Assessment, Development, and Evaluation (GRADE).
In total 229 studies were included. Analysis of publication bias suggested a 10% overstatement of treatment effects. Studies published in peer-review journals reported greater effects than online studies (R2=9·3%, p<0·01). Trial outcomes were generally modest even for effective drugs : in particular NNTs were 3·6 (95 % CI 3·0–4·4) for tricyclic antidepressants (TCAs), 6·4 (95 % CI 5·2–8·4) for serotonin- noradrenaline reuptake inbibitor (SNRI) antidepressants duloxetine and venlafaxine, 7·7 (95 % CI 6·5–9·4) for pregabalin and 6·3 (95 % CI 5·0–8·3) for gabapentin. NNTs were higher for gabapentin ER/enacarbil and capsaicin high concentration patches, lower for opioids and botulinum toxin A (BTX-A) and undetermined for lidocaine patches. Final quality of evidence was lower for lidocaine patches and BTX-A. Tolerability/safety and values/preferences were high for lidocaine patches and lower for opioids and TCAs. This permitted a strong GRADE recommendation for use and proposal as first line for TCAs, SNRIs, pregabalin, gabapentin and gabapentin ER/enacarbil in neuropathic pain, a weak recommendation for use and proposal as second line for lidocaine patches, capsaicin patches and tramadol, and a weak recommendations for use and proposal as third line for strong opioids (particularly oxycodone and morphine) and BTX-A. Data for cannabinoids, tapentadol, drug combinations, and several other antiepileptics, antidepressants and topical drugs were inconclusive.
Limited efficacy, large placebo responses, inadequate diagnostic criteria and poor phenotypic profiling probably account for modest trial outcomes and should be taken into account in future studies.
This study was funded by NeuPSIG.
Url:
DOI: 10.1016/S1474-4422(14)70251-0
PubMed: 25575710
PubMed Central: 4493167
Affiliations:
- Afrique du Sud, Allemagne, Australie, Canada, Danemark, Finlande, France, Royaume-Uni, Suède, États-Unis
- Angleterre, Californie, Gauteng, Grand Londres, Maryland, Massachusetts, Missouri (État), Nouvelle-Galles du Sud, Oxfordshire, Schleswig-Holstein, Svealand, Victoria (État), Écosse, État de New York, Île-de-France
- Boulogne-Billancourt, Johannesbourg, Kiel, Londres, Melbourne, Oxford, San Diego, San Francisco, Stockholm, Sydney, Édimbourg
- Université d'Édimbourg, Université de Sydney, Université du Witwatersrand
Links toward previous steps (curation, corpus...)
- to stream Pmc, to step Corpus: 001E09
- to stream Pmc, to step Curation: 001C65
- to stream Pmc, to step Checkpoint: 000E02
- to stream PubMed, to step Corpus: 003061
- to stream PubMed, to step Curation: 002F80
- to stream PubMed, to step Checkpoint: 002F80
- to stream Ncbi, to step Merge: 002154
- to stream Ncbi, to step Curation: 002154
- to stream Ncbi, to step Checkpoint: 002154
- to stream Main, to step Merge: 002A20
- to stream Main, to step Curation: 002A20
Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Pharmacotherapy for neuropathic pain in adults: systematic review, meta-analysis and updated NeuPSIG recommendations</title><author><name sortKey="Finnerup, Nanna B" sort="Finnerup, Nanna B" uniqKey="Finnerup N" first="Nanna B" last="Finnerup">Nanna B. Finnerup</name><affiliation wicri:level="1"><nlm:aff id="A1">Danish Pain Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark</nlm:aff><country xml:lang="fr">Danemark</country><wicri:regionArea>Danish Pain Research Center, Department of Clinical Medicine, Aarhus University, Aarhus</wicri:regionArea><wicri:noRegion>Aarhus</wicri:noRegion></affiliation></author><author><name sortKey="Attal, Nadine" sort="Attal, Nadine" uniqKey="Attal N" first="Nadine" last="Attal">Nadine Attal</name><affiliation wicri:level="3"><nlm:aff id="A2">INSERM U-987, Centre d’Evaluation et de Traitement de la Douleur, Hôpital Ambroise Paré, APHP, Boulogne-Billancourt, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>INSERM U-987, Centre d’Evaluation et de Traitement de la Douleur, Hôpital Ambroise Paré, APHP, Boulogne-Billancourt</wicri:regionArea><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Boulogne-Billancourt</settlement></placeName></affiliation><affiliation wicri:level="1"><nlm:aff id="A3">Université Versailles Saint-Quentin, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Université Versailles Saint-Quentin</wicri:regionArea></affiliation></author><author><name sortKey="Haroutounian, Simon" sort="Haroutounian, Simon" uniqKey="Haroutounian S" first="Simon" last="Haroutounian">Simon Haroutounian</name><affiliation wicri:level="2"><nlm:aff id="A4">Division of Clinical and Translational Research, Department of Anesthesiology, Washington University Scool of Medicine, St Louis, MO, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Division of Clinical and Translational Research, Department of Anesthesiology, Washington University Scool of Medicine, St Louis, MO</wicri:regionArea><placeName><region type="state">Missouri (État)</region></placeName></affiliation></author><author><name sortKey="Mcnicol, Ewan" sort="Mcnicol, Ewan" uniqKey="Mcnicol E" first="Ewan" last="Mcnicol">Ewan Mcnicol</name><affiliation wicri:level="2"><nlm:aff id="A5">Departments of Anesthesiology and Pharmacy, Tufts Medical Center, Boston, MA, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Departments of Anesthesiology and Pharmacy, Tufts Medical Center, Boston, MA</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Baron, Ralf" sort="Baron, Ralf" uniqKey="Baron R" first="Ralf" last="Baron">Ralf Baron</name><affiliation wicri:level="3"><nlm:aff id="A6">Division of Neurological Pain Research and Therapy, Department of Neurology, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Division of Neurological Pain Research and Therapy, Department of Neurology, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel</wicri:regionArea><placeName><region type="land" nuts="2">Schleswig-Holstein</region><settlement type="city">Kiel</settlement></placeName></affiliation></author><author><name sortKey="Dworkin, Robert H" sort="Dworkin, Robert H" uniqKey="Dworkin R" first="Robert H" last="Dworkin">Robert H. Dworkin</name><affiliation wicri:level="2"><nlm:aff id="A7">Department of Anesthesiology, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA and Department of Neurology, Center for Human Experimental Therapeutics, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Anesthesiology, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA and Department of Neurology, Center for Human Experimental Therapeutics, University of Rochester School of Medicine and Dentistry, Rochester, NY</wicri:regionArea><placeName><region type="state">État de New York</region></placeName></affiliation></author><author><name sortKey="Gilron, Ian" sort="Gilron, Ian" uniqKey="Gilron I" first="Ian" last="Gilron">Ian Gilron</name><affiliation wicri:level="1"><nlm:aff id="A8">Department of Anesthesiology & Perioperative Medicine and Biomedical & Molecular Sciences, Queen’s University, Kingston, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Department of Anesthesiology & Perioperative Medicine and Biomedical & Molecular Sciences, Queen’s University, Kingston</wicri:regionArea><wicri:noRegion>Kingston</wicri:noRegion></affiliation></author><author><name sortKey="Haanpaa, Maija" sort="Haanpaa, Maija" uniqKey="Haanpaa M" first="Maija" last="Haanpaa">Maija Haanpaa</name><affiliation wicri:level="1"><nlm:aff id="A9">Department of Neurosurgery, Helsinki University Central Hospital, Helsinki, Finland; Mutual Insurance Company Etera, Helsinki, Finland</nlm:aff><country xml:lang="fr">Finlande</country><wicri:regionArea>Department of Neurosurgery, Helsinki University Central Hospital, Helsinki, Finland; Mutual Insurance Company Etera, Helsinki</wicri:regionArea><wicri:noRegion>Helsinki</wicri:noRegion></affiliation></author><author><name sortKey="Hansson, Per" sort="Hansson, Per" uniqKey="Hansson P" first="Per" last="Hansson">Per Hansson</name><affiliation wicri:level="3"><nlm:aff id="A10">Dept. of Pain Management and Research, Oslo University Hospital, Oslo, Norway and Dept. of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden</nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea>Dept. of Pain Management and Research, Oslo University Hospital, Oslo, Norway and Dept. of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm</wicri:regionArea><placeName><settlement type="city">Stockholm</settlement><region nuts="2">Svealand</region></placeName></affiliation></author><author><name sortKey="Jensen, Troels S" sort="Jensen, Troels S" uniqKey="Jensen T" first="Troels S" last="Jensen">Troels S. Jensen</name><affiliation wicri:level="1"><nlm:aff id="A1">Danish Pain Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark</nlm:aff><country xml:lang="fr">Danemark</country><wicri:regionArea>Danish Pain Research Center, Department of Clinical Medicine, Aarhus University, Aarhus</wicri:regionArea><wicri:noRegion>Aarhus</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="A11">Department of Neurology, Aarhus University Hospital, Aarhus, Denmark</nlm:aff><country xml:lang="fr">Danemark</country><wicri:regionArea>Department of Neurology, Aarhus University Hospital, Aarhus</wicri:regionArea><wicri:noRegion>Aarhus</wicri:noRegion></affiliation></author><author><name sortKey="Kamerman, Peter R" sort="Kamerman, Peter R" uniqKey="Kamerman P" first="Peter R" last="Kamerman">Peter R. Kamerman</name><affiliation wicri:level="4"><nlm:aff id="A12">Brain Function Research Group, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, South Africa</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Brain Function Research Group, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand</wicri:regionArea><placeName><settlement type="city">Johannesbourg</settlement><region type="region" nuts="2">Gauteng</region></placeName><orgName type="university">Université du Witwatersrand</orgName></affiliation></author><author><name sortKey="Lund, Karen" sort="Lund, Karen" uniqKey="Lund K" first="Karen" last="Lund">Karen Lund</name><affiliation wicri:level="1"><nlm:aff id="A1">Danish Pain Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark</nlm:aff><country xml:lang="fr">Danemark</country><wicri:regionArea>Danish Pain Research Center, Department of Clinical Medicine, Aarhus University, Aarhus</wicri:regionArea><wicri:noRegion>Aarhus</wicri:noRegion></affiliation></author><author><name sortKey="Moore, Andrew" sort="Moore, Andrew" uniqKey="Moore A" first="Andrew" last="Moore">Andrew Moore</name><affiliation wicri:level="3"><nlm:aff id="A13">Nuffield Division of Anaesthetics, Nuffield Department of Clinical Neurosciences, Pain Research, The Churchill, Oxford, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Nuffield Division of Anaesthetics, Nuffield Department of Clinical Neurosciences, Pain Research, The Churchill, Oxford</wicri:regionArea><placeName><settlement type="city">Oxford</settlement><region type="country">Angleterre</region><region type="comté" nuts="2">Oxfordshire</region></placeName></affiliation></author><author><name sortKey="Raja, Srinivasa N" sort="Raja, Srinivasa N" uniqKey="Raja S" first="Srinivasa N" last="Raja">Srinivasa N. Raja</name><affiliation wicri:level="2"><nlm:aff id="A14">Johns Hopkins School of Medicine, Division of Pain Medicine, Department of Anesthesiology and Critical Care Medicine, Baltimore, MD, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Johns Hopkins School of Medicine, Division of Pain Medicine, Department of Anesthesiology and Critical Care Medicine, Baltimore, MD</wicri:regionArea><placeName><region type="state">Maryland</region></placeName></affiliation></author><author><name sortKey="Rice, Andrew Sc" sort="Rice, Andrew Sc" uniqKey="Rice A" first="Andrew Sc" last="Rice">Andrew Sc Rice</name><affiliation wicri:level="3"><nlm:aff id="A15">Pain Research, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, UK and Hon. Consultant in Pain Medicine, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Pain Research, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, UK and Hon. Consultant in Pain Medicine, Chelsea and Westminster Hospital NHS Foundation Trust, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Rowbotham, Michael" sort="Rowbotham, Michael" uniqKey="Rowbotham M" first="Michael" last="Rowbotham">Michael Rowbotham</name><affiliation wicri:level="3"><nlm:aff id="A16">California Pacific Medical Center Research Institute and UCSF Pain Management Center, San Francisco, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>California Pacific Medical Center Research Institute and UCSF Pain Management Center, San Francisco</wicri:regionArea><placeName><settlement type="city">San Francisco</settlement><region type="state">Californie</region></placeName></affiliation></author><author><name sortKey="Sena, Emily" sort="Sena, Emily" uniqKey="Sena E" first="Emily" last="Sena">Emily Sena</name><affiliation wicri:level="4"><nlm:aff id="A17">Division of Clinical Neurosciences, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK and Florey Institute of Neuroscience and Mental Health, Melbourne, Australia</nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>Division of Clinical Neurosciences, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK and Florey Institute of Neuroscience and Mental Health, Melbourne</wicri:regionArea><placeName><settlement type="city">Melbourne</settlement><region type="état">Victoria (État)</region><settlement type="city">Édimbourg</settlement></placeName><orgName type="university">Université d'Édimbourg</orgName></affiliation></author><author><name sortKey="Siddall, Philip" sort="Siddall, Philip" uniqKey="Siddall P" first="Philip" last="Siddall">Philip Siddall</name><affiliation wicri:level="4"><nlm:aff id="A18">Department of Pain Management, Greenwich Hospital, HammondCare, Sydney NSW Australia; and Kolling Institute, Sydney Medical School-Northern, University of Sydney, Sydney NSW Australia</nlm:aff><orgName type="university">Université de Sydney</orgName><country>Australie</country><placeName><settlement type="city">Sydney</settlement><region type="état">Nouvelle-Galles du Sud</region></placeName></affiliation></author><author><name sortKey="Smith, Blair H" sort="Smith, Blair H" uniqKey="Smith B" first="Blair H" last="Smith">Blair H. Smith</name><affiliation wicri:level="2"><nlm:aff id="A19">Division of Population Health Sciences, University of Dundee, Ninewells Hospital and Medical School, Dundee, Scotland</nlm:aff><country>Royaume-Uni</country><placeName><region type="country">Écosse</region></placeName><wicri:cityArea>Division of Population Health Sciences, University of Dundee, Ninewells Hospital and Medical School, Dundee</wicri:cityArea></affiliation></author><author><name sortKey="Wallace, Mark" sort="Wallace, Mark" uniqKey="Wallace M" first="Mark" last="Wallace">Mark Wallace</name><affiliation wicri:level="3"><nlm:aff id="A20">Division of Pain Medicine, Department of Anesthesiology, University of California, San Diego, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Division of Pain Medicine, Department of Anesthesiology, University of California, San Diego</wicri:regionArea><placeName><settlement type="city">San Diego</settlement><region type="state">Californie</region></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">25575710</idno><idno type="pmc">4493167</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4493167</idno><idno type="RBID">PMC:4493167</idno><idno type="doi">10.1016/S1474-4422(14)70251-0</idno><date when="2015">2015</date><idno type="wicri:Area/Pmc/Corpus">001E09</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001E09</idno><idno type="wicri:Area/Pmc/Curation">001C65</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">001C65</idno><idno type="wicri:Area/Pmc/Checkpoint">000E02</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000E02</idno><idno type="wicri:source">PubMed</idno><idno type="wicri:Area/PubMed/Corpus">003061</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">003061</idno><idno type="wicri:Area/PubMed/Curation">002F80</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Curation">002F80</idno><idno type="wicri:Area/PubMed/Checkpoint">002F80</idno><idno type="wicri:explorRef" wicri:stream="Checkpoint" wicri:step="PubMed">002F80</idno><idno type="wicri:Area/Ncbi/Merge">002154</idno><idno type="wicri:Area/Ncbi/Curation">002154</idno><idno type="wicri:Area/Ncbi/Checkpoint">002154</idno><idno type="wicri:doubleKey">1474-4422:2015:Finnerup N:pharmacotherapy:for:neuropathic</idno><idno type="wicri:Area/Main/Merge">002A20</idno><idno type="wicri:Area/Main/Curation">002A20</idno><idno type="wicri:Area/Main/Exploration">002A20</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Pharmacotherapy for neuropathic pain in adults: systematic review, meta-analysis and updated NeuPSIG recommendations</title><author><name sortKey="Finnerup, Nanna B" sort="Finnerup, Nanna B" uniqKey="Finnerup N" first="Nanna B" last="Finnerup">Nanna B. Finnerup</name><affiliation wicri:level="1"><nlm:aff id="A1">Danish Pain Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark</nlm:aff><country xml:lang="fr">Danemark</country><wicri:regionArea>Danish Pain Research Center, Department of Clinical Medicine, Aarhus University, Aarhus</wicri:regionArea><wicri:noRegion>Aarhus</wicri:noRegion></affiliation></author><author><name sortKey="Attal, Nadine" sort="Attal, Nadine" uniqKey="Attal N" first="Nadine" last="Attal">Nadine Attal</name><affiliation wicri:level="3"><nlm:aff id="A2">INSERM U-987, Centre d’Evaluation et de Traitement de la Douleur, Hôpital Ambroise Paré, APHP, Boulogne-Billancourt, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>INSERM U-987, Centre d’Evaluation et de Traitement de la Douleur, Hôpital Ambroise Paré, APHP, Boulogne-Billancourt</wicri:regionArea><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Boulogne-Billancourt</settlement></placeName></affiliation><affiliation wicri:level="1"><nlm:aff id="A3">Université Versailles Saint-Quentin, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Université Versailles Saint-Quentin</wicri:regionArea></affiliation></author><author><name sortKey="Haroutounian, Simon" sort="Haroutounian, Simon" uniqKey="Haroutounian S" first="Simon" last="Haroutounian">Simon Haroutounian</name><affiliation wicri:level="2"><nlm:aff id="A4">Division of Clinical and Translational Research, Department of Anesthesiology, Washington University Scool of Medicine, St Louis, MO, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Division of Clinical and Translational Research, Department of Anesthesiology, Washington University Scool of Medicine, St Louis, MO</wicri:regionArea><placeName><region type="state">Missouri (État)</region></placeName></affiliation></author><author><name sortKey="Mcnicol, Ewan" sort="Mcnicol, Ewan" uniqKey="Mcnicol E" first="Ewan" last="Mcnicol">Ewan Mcnicol</name><affiliation wicri:level="2"><nlm:aff id="A5">Departments of Anesthesiology and Pharmacy, Tufts Medical Center, Boston, MA, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Departments of Anesthesiology and Pharmacy, Tufts Medical Center, Boston, MA</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Baron, Ralf" sort="Baron, Ralf" uniqKey="Baron R" first="Ralf" last="Baron">Ralf Baron</name><affiliation wicri:level="3"><nlm:aff id="A6">Division of Neurological Pain Research and Therapy, Department of Neurology, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Division of Neurological Pain Research and Therapy, Department of Neurology, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel</wicri:regionArea><placeName><region type="land" nuts="2">Schleswig-Holstein</region><settlement type="city">Kiel</settlement></placeName></affiliation></author><author><name sortKey="Dworkin, Robert H" sort="Dworkin, Robert H" uniqKey="Dworkin R" first="Robert H" last="Dworkin">Robert H. Dworkin</name><affiliation wicri:level="2"><nlm:aff id="A7">Department of Anesthesiology, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA and Department of Neurology, Center for Human Experimental Therapeutics, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Anesthesiology, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA and Department of Neurology, Center for Human Experimental Therapeutics, University of Rochester School of Medicine and Dentistry, Rochester, NY</wicri:regionArea><placeName><region type="state">État de New York</region></placeName></affiliation></author><author><name sortKey="Gilron, Ian" sort="Gilron, Ian" uniqKey="Gilron I" first="Ian" last="Gilron">Ian Gilron</name><affiliation wicri:level="1"><nlm:aff id="A8">Department of Anesthesiology & Perioperative Medicine and Biomedical & Molecular Sciences, Queen’s University, Kingston, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Department of Anesthesiology & Perioperative Medicine and Biomedical & Molecular Sciences, Queen’s University, Kingston</wicri:regionArea><wicri:noRegion>Kingston</wicri:noRegion></affiliation></author><author><name sortKey="Haanpaa, Maija" sort="Haanpaa, Maija" uniqKey="Haanpaa M" first="Maija" last="Haanpaa">Maija Haanpaa</name><affiliation wicri:level="1"><nlm:aff id="A9">Department of Neurosurgery, Helsinki University Central Hospital, Helsinki, Finland; Mutual Insurance Company Etera, Helsinki, Finland</nlm:aff><country xml:lang="fr">Finlande</country><wicri:regionArea>Department of Neurosurgery, Helsinki University Central Hospital, Helsinki, Finland; Mutual Insurance Company Etera, Helsinki</wicri:regionArea><wicri:noRegion>Helsinki</wicri:noRegion></affiliation></author><author><name sortKey="Hansson, Per" sort="Hansson, Per" uniqKey="Hansson P" first="Per" last="Hansson">Per Hansson</name><affiliation wicri:level="3"><nlm:aff id="A10">Dept. of Pain Management and Research, Oslo University Hospital, Oslo, Norway and Dept. of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden</nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea>Dept. of Pain Management and Research, Oslo University Hospital, Oslo, Norway and Dept. of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm</wicri:regionArea><placeName><settlement type="city">Stockholm</settlement><region nuts="2">Svealand</region></placeName></affiliation></author><author><name sortKey="Jensen, Troels S" sort="Jensen, Troels S" uniqKey="Jensen T" first="Troels S" last="Jensen">Troels S. Jensen</name><affiliation wicri:level="1"><nlm:aff id="A1">Danish Pain Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark</nlm:aff><country xml:lang="fr">Danemark</country><wicri:regionArea>Danish Pain Research Center, Department of Clinical Medicine, Aarhus University, Aarhus</wicri:regionArea><wicri:noRegion>Aarhus</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="A11">Department of Neurology, Aarhus University Hospital, Aarhus, Denmark</nlm:aff><country xml:lang="fr">Danemark</country><wicri:regionArea>Department of Neurology, Aarhus University Hospital, Aarhus</wicri:regionArea><wicri:noRegion>Aarhus</wicri:noRegion></affiliation></author><author><name sortKey="Kamerman, Peter R" sort="Kamerman, Peter R" uniqKey="Kamerman P" first="Peter R" last="Kamerman">Peter R. Kamerman</name><affiliation wicri:level="4"><nlm:aff id="A12">Brain Function Research Group, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, South Africa</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Brain Function Research Group, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand</wicri:regionArea><placeName><settlement type="city">Johannesbourg</settlement><region type="region" nuts="2">Gauteng</region></placeName><orgName type="university">Université du Witwatersrand</orgName></affiliation></author><author><name sortKey="Lund, Karen" sort="Lund, Karen" uniqKey="Lund K" first="Karen" last="Lund">Karen Lund</name><affiliation wicri:level="1"><nlm:aff id="A1">Danish Pain Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark</nlm:aff><country xml:lang="fr">Danemark</country><wicri:regionArea>Danish Pain Research Center, Department of Clinical Medicine, Aarhus University, Aarhus</wicri:regionArea><wicri:noRegion>Aarhus</wicri:noRegion></affiliation></author><author><name sortKey="Moore, Andrew" sort="Moore, Andrew" uniqKey="Moore A" first="Andrew" last="Moore">Andrew Moore</name><affiliation wicri:level="3"><nlm:aff id="A13">Nuffield Division of Anaesthetics, Nuffield Department of Clinical Neurosciences, Pain Research, The Churchill, Oxford, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Nuffield Division of Anaesthetics, Nuffield Department of Clinical Neurosciences, Pain Research, The Churchill, Oxford</wicri:regionArea><placeName><settlement type="city">Oxford</settlement><region type="country">Angleterre</region><region type="comté" nuts="2">Oxfordshire</region></placeName></affiliation></author><author><name sortKey="Raja, Srinivasa N" sort="Raja, Srinivasa N" uniqKey="Raja S" first="Srinivasa N" last="Raja">Srinivasa N. Raja</name><affiliation wicri:level="2"><nlm:aff id="A14">Johns Hopkins School of Medicine, Division of Pain Medicine, Department of Anesthesiology and Critical Care Medicine, Baltimore, MD, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Johns Hopkins School of Medicine, Division of Pain Medicine, Department of Anesthesiology and Critical Care Medicine, Baltimore, MD</wicri:regionArea><placeName><region type="state">Maryland</region></placeName></affiliation></author><author><name sortKey="Rice, Andrew Sc" sort="Rice, Andrew Sc" uniqKey="Rice A" first="Andrew Sc" last="Rice">Andrew Sc Rice</name><affiliation wicri:level="3"><nlm:aff id="A15">Pain Research, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, UK and Hon. Consultant in Pain Medicine, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Pain Research, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, UK and Hon. Consultant in Pain Medicine, Chelsea and Westminster Hospital NHS Foundation Trust, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Rowbotham, Michael" sort="Rowbotham, Michael" uniqKey="Rowbotham M" first="Michael" last="Rowbotham">Michael Rowbotham</name><affiliation wicri:level="3"><nlm:aff id="A16">California Pacific Medical Center Research Institute and UCSF Pain Management Center, San Francisco, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>California Pacific Medical Center Research Institute and UCSF Pain Management Center, San Francisco</wicri:regionArea><placeName><settlement type="city">San Francisco</settlement><region type="state">Californie</region></placeName></affiliation></author><author><name sortKey="Sena, Emily" sort="Sena, Emily" uniqKey="Sena E" first="Emily" last="Sena">Emily Sena</name><affiliation wicri:level="4"><nlm:aff id="A17">Division of Clinical Neurosciences, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK and Florey Institute of Neuroscience and Mental Health, Melbourne, Australia</nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>Division of Clinical Neurosciences, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK and Florey Institute of Neuroscience and Mental Health, Melbourne</wicri:regionArea><placeName><settlement type="city">Melbourne</settlement><region type="état">Victoria (État)</region><settlement type="city">Édimbourg</settlement></placeName><orgName type="university">Université d'Édimbourg</orgName></affiliation></author><author><name sortKey="Siddall, Philip" sort="Siddall, Philip" uniqKey="Siddall P" first="Philip" last="Siddall">Philip Siddall</name><affiliation wicri:level="4"><nlm:aff id="A18">Department of Pain Management, Greenwich Hospital, HammondCare, Sydney NSW Australia; and Kolling Institute, Sydney Medical School-Northern, University of Sydney, Sydney NSW Australia</nlm:aff><orgName type="university">Université de Sydney</orgName><country>Australie</country><placeName><settlement type="city">Sydney</settlement><region type="état">Nouvelle-Galles du Sud</region></placeName></affiliation></author><author><name sortKey="Smith, Blair H" sort="Smith, Blair H" uniqKey="Smith B" first="Blair H" last="Smith">Blair H. Smith</name><affiliation wicri:level="2"><nlm:aff id="A19">Division of Population Health Sciences, University of Dundee, Ninewells Hospital and Medical School, Dundee, Scotland</nlm:aff><country>Royaume-Uni</country><placeName><region type="country">Écosse</region></placeName><wicri:cityArea>Division of Population Health Sciences, University of Dundee, Ninewells Hospital and Medical School, Dundee</wicri:cityArea></affiliation></author><author><name sortKey="Wallace, Mark" sort="Wallace, Mark" uniqKey="Wallace M" first="Mark" last="Wallace">Mark Wallace</name><affiliation wicri:level="3"><nlm:aff id="A20">Division of Pain Medicine, Department of Anesthesiology, University of California, San Diego, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Division of Pain Medicine, Department of Anesthesiology, University of California, San Diego</wicri:regionArea><placeName><settlement type="city">San Diego</settlement><region type="state">Californie</region></placeName></affiliation></author></analytic><series><title level="j">The Lancet. Neurology</title><idno type="ISSN">1474-4422</idno><idno type="eISSN">1474-4465</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Analgesics, Opioid (therapeutic use)</term><term>Antidepressive Agents, Tricyclic (therapeutic use)</term><term>Humans</term><term>Neuralgia (diagnosis)</term><term>Neuralgia (drug therapy)</term><term>Pain Management (methods)</term><term>Randomized Controlled Trials as Topic (methods)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte</term><term>Analgésiques morphiniques (usage thérapeutique)</term><term>Antidépresseurs tricycliques (usage thérapeutique)</term><term>Essais contrôlés randomisés comme sujet ()</term><term>Gestion de la douleur ()</term><term>Humains</term><term>Névralgie (diagnostic)</term><term>Névralgie (traitement médicamenteux)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Analgesics, Opioid</term><term>Antidepressive Agents, Tricyclic</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Neuralgia</term></keywords><keywords scheme="MESH" qualifier="diagnostic" xml:lang="fr"><term>Névralgie</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Neuralgia</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Pain Management</term><term>Randomized Controlled Trials as Topic</term></keywords><keywords scheme="MESH" qualifier="traitement médicamenteux" xml:lang="fr"><term>Névralgie</term></keywords><keywords scheme="MESH" qualifier="usage thérapeutique" xml:lang="fr"><term>Analgésiques morphiniques</term><term>Antidépresseurs tricycliques</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Humans</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte</term><term>Essais contrôlés randomisés comme sujet</term><term>Gestion de la douleur</term><term>Humains</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><title>Summary</title><sec id="S1"><title>Background</title><p id="P1">Neuropathic pain is difficult to treat. New treatments, clinical trials and standards of quality for assessing evidence justify an update of evidence-based recommendations for its pharmacological treatment.</p></sec><sec id="S2"><title>Methods</title><p id="P2">The Neuropathic Pain Special Interest Group (NeuPSIG) of the International Association for the Study of Pain conducted a systematic review of randomised double-blind studies of oral and topical pharmacotherapy for neuropathic pain, including unpublished trials (retrieved from clinicaltrials.gov and pharmaceutical websites). Meta-analysis used Numbers Needed to Treat (NNT) for 50 % pain relief as primary measure and assessed publication bias. Recommendations used the Grading of Recommendations Assessment, Development, and Evaluation (GRADE).</p></sec><sec id="S3"><title>Findings</title><p id="P3">In total 229 studies were included. Analysis of publication bias suggested a 10% overstatement of treatment effects. Studies published in peer-review journals reported greater effects than online studies (R<sup>2</sup>=9·3%, p<0·01). Trial outcomes were generally modest even for effective drugs : in particular NNTs were 3·6 (95 % CI 3·0–4·4) for tricyclic antidepressants (TCAs), 6·4 (95 % CI 5·2–8·4) for serotonin- noradrenaline reuptake inbibitor (SNRI) antidepressants duloxetine and venlafaxine, 7·7 (95 % CI 6·5–9·4) for pregabalin and 6·3 (95 % CI 5·0–8·3) for gabapentin. NNTs were higher for gabapentin ER/enacarbil and capsaicin high concentration patches, lower for opioids and botulinum toxin A (BTX-A) and undetermined for lidocaine patches. Final quality of evidence was lower for lidocaine patches and BTX-A. Tolerability/safety and values/preferences were high for lidocaine patches and lower for opioids and TCAs. This permitted a strong GRADE recommendation for use and proposal as first line for TCAs, SNRIs, pregabalin, gabapentin and gabapentin ER/enacarbil in neuropathic pain, a weak recommendation for use and proposal as second line for lidocaine patches, capsaicin patches and tramadol, and a weak recommendations for use and proposal as third line for strong opioids (particularly oxycodone and morphine) and BTX-A. Data for cannabinoids, tapentadol, drug combinations, and several other antiepileptics, antidepressants and topical drugs were inconclusive.</p></sec><sec id="S4"><title>Interpretation</title><p id="P4">Limited efficacy, large placebo responses, inadequate diagnostic criteria and poor phenotypic profiling probably account for modest trial outcomes and should be taken into account in future studies.</p></sec><sec id="S5"><title>Funding</title><p id="P5">This study was funded by NeuPSIG.</p></sec></div></front></TEI><affiliations><list><country><li>Afrique du Sud</li><li>Allemagne</li><li>Australie</li><li>Canada</li><li>Danemark</li><li>Finlande</li><li>France</li><li>Royaume-Uni</li><li>Suède</li><li>États-Unis</li></country><region><li>Angleterre</li><li>Californie</li><li>Gauteng</li><li>Grand Londres</li><li>Maryland</li><li>Massachusetts</li><li>Missouri (État)</li><li>Nouvelle-Galles du Sud</li><li>Oxfordshire</li><li>Schleswig-Holstein</li><li>Svealand</li><li>Victoria (État)</li><li>Écosse</li><li>État de New York</li><li>Île-de-France</li></region><settlement><li>Boulogne-Billancourt</li><li>Johannesbourg</li><li>Kiel</li><li>Londres</li><li>Melbourne</li><li>Oxford</li><li>San Diego</li><li>San Francisco</li><li>Stockholm</li><li>Sydney</li><li>Édimbourg</li></settlement><orgName><li>Université d'Édimbourg</li><li>Université de Sydney</li><li>Université du Witwatersrand</li></orgName></list><tree><country name="Danemark"><noRegion><name sortKey="Finnerup, Nanna B" sort="Finnerup, Nanna B" uniqKey="Finnerup N" first="Nanna B" last="Finnerup">Nanna B. Finnerup</name></noRegion><name sortKey="Jensen, Troels S" sort="Jensen, Troels S" uniqKey="Jensen T" first="Troels S" last="Jensen">Troels S. Jensen</name><name sortKey="Jensen, Troels S" sort="Jensen, Troels S" uniqKey="Jensen T" first="Troels S" last="Jensen">Troels S. Jensen</name><name sortKey="Lund, Karen" sort="Lund, Karen" uniqKey="Lund K" first="Karen" last="Lund">Karen Lund</name></country><country name="France"><region name="Île-de-France"><name sortKey="Attal, Nadine" sort="Attal, Nadine" uniqKey="Attal N" first="Nadine" last="Attal">Nadine Attal</name></region><name sortKey="Attal, Nadine" sort="Attal, Nadine" uniqKey="Attal N" first="Nadine" last="Attal">Nadine Attal</name></country><country name="États-Unis"><region name="Missouri (État)"><name sortKey="Haroutounian, Simon" sort="Haroutounian, Simon" uniqKey="Haroutounian S" first="Simon" last="Haroutounian">Simon Haroutounian</name></region><name sortKey="Dworkin, Robert H" sort="Dworkin, Robert H" uniqKey="Dworkin R" first="Robert H" last="Dworkin">Robert H. Dworkin</name><name sortKey="Mcnicol, Ewan" sort="Mcnicol, Ewan" uniqKey="Mcnicol E" first="Ewan" last="Mcnicol">Ewan Mcnicol</name><name sortKey="Raja, Srinivasa N" sort="Raja, Srinivasa N" uniqKey="Raja S" first="Srinivasa N" last="Raja">Srinivasa N. Raja</name><name sortKey="Rowbotham, Michael" sort="Rowbotham, Michael" uniqKey="Rowbotham M" first="Michael" last="Rowbotham">Michael Rowbotham</name><name sortKey="Wallace, Mark" sort="Wallace, Mark" uniqKey="Wallace M" first="Mark" last="Wallace">Mark Wallace</name></country><country name="Allemagne"><region name="Schleswig-Holstein"><name sortKey="Baron, Ralf" sort="Baron, Ralf" uniqKey="Baron R" first="Ralf" last="Baron">Ralf Baron</name></region></country><country name="Canada"><noRegion><name sortKey="Gilron, Ian" sort="Gilron, Ian" uniqKey="Gilron I" first="Ian" last="Gilron">Ian Gilron</name></noRegion></country><country name="Finlande"><noRegion><name sortKey="Haanpaa, Maija" sort="Haanpaa, Maija" uniqKey="Haanpaa M" first="Maija" last="Haanpaa">Maija Haanpaa</name></noRegion></country><country name="Suède"><region name="Svealand"><name sortKey="Hansson, Per" sort="Hansson, Per" uniqKey="Hansson P" first="Per" last="Hansson">Per Hansson</name></region></country><country name="Afrique du Sud"><region name="Gauteng"><name sortKey="Kamerman, Peter R" sort="Kamerman, Peter R" uniqKey="Kamerman P" first="Peter R" last="Kamerman">Peter R. Kamerman</name></region></country><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Moore, Andrew" sort="Moore, Andrew" uniqKey="Moore A" first="Andrew" last="Moore">Andrew Moore</name></region><name sortKey="Rice, Andrew Sc" sort="Rice, Andrew Sc" uniqKey="Rice A" first="Andrew Sc" last="Rice">Andrew Sc Rice</name><name sortKey="Smith, Blair H" sort="Smith, Blair H" uniqKey="Smith B" first="Blair H" last="Smith">Blair H. Smith</name></country><country name="Australie"><region name="Victoria (État)"><name sortKey="Sena, Emily" sort="Sena, Emily" uniqKey="Sena E" first="Emily" last="Sena">Emily Sena</name></region><name sortKey="Siddall, Philip" sort="Siddall, Philip" uniqKey="Siddall P" first="Philip" last="Siddall">Philip Siddall</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Wicri/Asie/explor/AustralieFrV1/Data/Main/Exploration
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 002A20 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Main/Exploration/biblio.hfd -nk 002A20 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien
|wiki= Wicri/Asie
|area= AustralieFrV1
|flux= Main
|étape= Exploration
|type= RBID
|clé= PMC:4493167
|texte= Pharmacotherapy for neuropathic pain in adults: systematic review, meta-analysis and updated NeuPSIG recommendations
}}
Pour générer des pages wiki
HfdIndexSelect -h $EXPLOR_AREA/Data/Main/Exploration/RBID.i -Sk "pubmed:25575710" \
| HfdSelect -Kh $EXPLOR_AREA/Data/Main/Exploration/biblio.hfd \
| NlmPubMed2Wicri -a AustralieFrV1
| This area was generated with Dilib version V0.6.33. |  |