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

• Autor(a) principal: Rolim, Luiz Clemente [UNIFESP]
• Data de Publicação: 2017
• Outros Autores: Koga da Silva, Edina M. [UNIFESP], De Sa, Joao Roberto [UNIFESP], Dib, Sergio Atala [UNIFESP]
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Institucional da UNIFESP
• Texto Completo: http://dx.doi.org/10.3389/fneur.2017.00285; https://repositorio.unifesp.br/handle/11600/53646
• topic: comorbidity; chronic neuropathic pain; diabetes mellitus; painful diabetic neuropathy; pain phenotype; randomized clinical trial; systematic review

Background: 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 pregabalin