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. 2018 Feb 23;3(2):e638.
doi: 10.1097/PR9.0000000000000638. eCollection 2018 Mar.

Neuropathic pain in leprosy: symptom profile characterization and comparison with neuropathic pain of other etiologies

Irina Raicher  1   2 , Patrick Raymond Nicolas Andre Ghislain Stump  1   3 , Simone Bega Harnik  4 , Rodrigo Alves de Oliveira  4 , Rosemari Baccarelli  3 , Lucia H S C Marciano  3 , Somei Ura  3 , Marcos C L Virmond  3 , Manoel Jacobsen Teixeira  1 , Daniel Ciampi de Andrade  1   2
Affiliations

Neuropathic pain in leprosy: symptom profile characterization and comparison with neuropathic pain of other etiologies

Irina Raicher et al. Pain Rep. .

Abstract

Introduction: Previous studies reported a high prevalence of neuropathic pain in leprosy, being especially present in "pharmacologically cured" patients. The presence of neuropathic pain in leprosy poses a supplementary burden in patient's quality of life, daily activities, and mood.

Objectives: The aim of this study was to assess whether neuropathic pain in leprosy has similar symptom profile as neuropathic pain of other etiologies and to retrospectively assess the efficacy of neuropathic pain medications regularly prescribed to leprosy.

Methods: Leprosy and nonleprosy patients had their neuropathic pain characterized by the neuropathic pain symptom inventory (NPSI, ranges from 0 to 100, with 100 being the maximal neuropathic pain intensity) in a first visit. In a second visit, leprosy patients who had significant pain and received pharmacological treatment in the first evaluation were reassessed (NPSI) and had their pain profile and treatment response further characterized, including information on drugs prescribed for neuropathic pain and their respective pain relief.

Results: The pain characteristics based on NPSI did not significantly differ between leprosy and nonleprosy neuropathic pain patients in visit 1 after correction for multiple analyses, and cluster analyses confirmed these findings (ie, no discrimination between leprosy and nonleprosy groups; Pearson χ2 = 0.072, P = 0.788). The assessment of pain relief response and the drugs taken by each patient, linear regression analysis showed that amitriptyline, when effective, had the highest percentage of analgesic relief.

Conclusions: Neuropathic pain in leprosy is as heterogeneous as neuropathic pain of other etiologies, further supporting the concept that neuropathic pain is a transetiological entity. Neuropathic pain in leprosy may respond to drugs usually used to control pain of neuropathic profile in general, and amitriptiline may constitute a potential candidate drug for future formal clinical trials aimed at controlling neuropathic pain in leprosy.

Keywords: Candidate drug; Leprosy; Neuropathic pain; Neuropathy; Symptom; Symptom profile.

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Conflict of interest statement

Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.

Figures

Figure 1.
Figure 1.
Strobe flow diagram from visit 1 and visit 2.
Figure 2.
Figure 2.
Symptom profiles' comparison between leprosy neuropathic pain and nonleprosy neuropathic pain. NPSI, neuropathic pain symptom inventory.
See this image and copyright information in PMC

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