A systematic review of treatment of Painful Diabetic Neuropathy by Pain Phenotype versus treatment Based on Medical comorbidities
Autor(a) principal: | |
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Data de Publicação: | 2017 |
Outros Autores: | , , |
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 |
Resumo: | 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 |
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Rolim, Luiz Clemente [UNIFESP]Koga da Silva, Edina M. [UNIFESP]De Sa, Joao Roberto [UNIFESP]Dib, Sergio Atala [UNIFESP]2020-06-26T16:30:35Z2020-06-26T16:30:35Z2017http://dx.doi.org/10.3389/fneur.2017.00285Frontiers In Neurology. Lausanne, v. 8, p. -, 2017.1664-2295https://repositorio.unifesp.br/handle/11600/53646WOS000403716600001.pdf10.3389/fneur.2017.00285WOS:000403716600001Background: 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(2) the preservation of thermal sensation or nociception anticipated a positive response to the topical treatment of painand, (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.Univ Fed Sao Paulo UNIFESP, Diabet Ctr, Endocrinol Div, Escola Paulista Med, Sao Paulo, BrazilUniv Fed Sao Paulo UNIFESP, Brazilian Cochrane Ctr, Escola Paulista Med, Sao Paulo, BrazilUniv Fed Sao Paulo UNIFESP, Diabet Ctr, Endocrinol Div, Escola Paulista Med, Sao Paulo, BrazilUniv Fed Sao Paulo UNIFESP, Brazilian Cochrane Ctr, Escola Paulista Med, Sao Paulo, BrazilWeb of Science-engFrontiers Media SaFrontiers In Neurologycomorbiditychronic neuropathic paindiabetes mellituspainful diabetic neuropathypain phenotyperandomized clinical trialsystematic reviewA systematic review of treatment of Painful Diabetic Neuropathy by Pain Phenotype versus treatment Based on Medical comorbiditiesinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleLausanne8info:eu-repo/semantics/openAccessreponame:Repositório Institucional da UNIFESPinstname:Universidade Federal de São Paulo (UNIFESP)instacron:UNIFESPORIGINALWOS000403716600001.pdfapplication/pdf124651${dspace.ui.url}/bitstream/11600/53646/1/WOS000403716600001.pdf684d7a91ab732ad7a7bc0b8127b00df9MD51open accessTEXTWOS000403716600001.pdf.txtWOS000403716600001.pdf.txtExtracted texttext/plain35323${dspace.ui.url}/bitstream/11600/53646/2/WOS000403716600001.pdf.txt3286fbd4ca0bcbe8e5a92eb3bbf14b99MD52open accessTHUMBNAILWOS000403716600001.pdf.jpgWOS000403716600001.pdf.jpgIM Thumbnailimage/jpeg6403${dspace.ui.url}/bitstream/11600/53646/4/WOS000403716600001.pdf.jpg901208df5797bfb5ca33a46efd5684bcMD54open access11600/536462022-08-01 09:49:54.316open accessoai:repositorio.unifesp.br:11600/53646Repositório InstitucionalPUBhttp://www.repositorio.unifesp.br/oai/requestopendoar:34652022-08-01T12:49:54Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)false |
dc.title.en.fl_str_mv |
A systematic review of treatment of Painful Diabetic Neuropathy by Pain Phenotype versus treatment Based on Medical comorbidities |
title |
A systematic review of treatment of Painful Diabetic Neuropathy by Pain Phenotype versus treatment Based on Medical comorbidities |
spellingShingle |
A systematic review of treatment of Painful Diabetic Neuropathy by Pain Phenotype versus treatment Based on Medical comorbidities Rolim, Luiz Clemente [UNIFESP] comorbidity chronic neuropathic pain diabetes mellitus painful diabetic neuropathy pain phenotype randomized clinical trial systematic review |
title_short |
A systematic review of treatment of Painful Diabetic Neuropathy by Pain Phenotype versus treatment Based on Medical comorbidities |
title_full |
A systematic review of treatment of Painful Diabetic Neuropathy by Pain Phenotype versus treatment Based on Medical comorbidities |
title_fullStr |
A systematic review of treatment of Painful Diabetic Neuropathy by Pain Phenotype versus treatment Based on Medical comorbidities |
title_full_unstemmed |
A systematic review of treatment of Painful Diabetic Neuropathy by Pain Phenotype versus treatment Based on Medical comorbidities |
title_sort |
A systematic review of treatment of Painful Diabetic Neuropathy by Pain Phenotype versus treatment Based on Medical comorbidities |
author |
Rolim, Luiz Clemente [UNIFESP] |
author_facet |
Rolim, Luiz Clemente [UNIFESP] Koga da Silva, Edina M. [UNIFESP] De Sa, Joao Roberto [UNIFESP] Dib, Sergio Atala [UNIFESP] |
author_role |
author |
author2 |
Koga da Silva, Edina M. [UNIFESP] De Sa, Joao Roberto [UNIFESP] Dib, Sergio Atala [UNIFESP] |
author2_role |
author author author |
dc.contributor.author.fl_str_mv |
Rolim, Luiz Clemente [UNIFESP] Koga da Silva, Edina M. [UNIFESP] De Sa, Joao Roberto [UNIFESP] Dib, Sergio Atala [UNIFESP] |
dc.subject.eng.fl_str_mv |
comorbidity chronic neuropathic pain diabetes mellitus painful diabetic neuropathy pain phenotype randomized clinical trial systematic review |
topic |
comorbidity chronic neuropathic pain diabetes mellitus painful diabetic neuropathy pain phenotype randomized clinical trial systematic review |
description |
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 |
publishDate |
2017 |
dc.date.issued.fl_str_mv |
2017 |
dc.date.accessioned.fl_str_mv |
2020-06-26T16:30:35Z |
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2020-06-26T16:30:35Z |
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info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/article |
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dc.identifier.].fl_str_mv |
http://dx.doi.org/10.3389/fneur.2017.00285 |
dc.identifier.citation.fl_str_mv |
Frontiers In Neurology. Lausanne, v. 8, p. -, 2017. |
dc.identifier.uri.fl_str_mv |
https://repositorio.unifesp.br/handle/11600/53646 |
dc.identifier.issn.none.fl_str_mv |
1664-2295 |
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WOS000403716600001.pdf |
dc.identifier.doi.none.fl_str_mv |
10.3389/fneur.2017.00285 |
dc.identifier.wos.none.fl_str_mv |
WOS:000403716600001 |
url |
http://dx.doi.org/10.3389/fneur.2017.00285 https://repositorio.unifesp.br/handle/11600/53646 |
identifier_str_mv |
Frontiers In Neurology. Lausanne, v. 8, p. -, 2017. 1664-2295 WOS000403716600001.pdf 10.3389/fneur.2017.00285 WOS:000403716600001 |
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eng |
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eng |
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Frontiers In Neurology |
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Frontiers Media Sa |
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Frontiers Media Sa |
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