Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2021 Apr 26:2021:6656863.
doi: 10.1155/2021/6656863. eCollection 2021.

Pharmacotherapeutic Options for Managing Neuropathic Pain: A Systematic Review and Meta-Analysis

Giulia Di Stefano  1 , Andrea Di Lionardo  1 , Giuseppe Di Pietro  1 , Giorgio Cruccu  1 , Andrea Truini  1
Affiliations
Meta-Analysis

Pharmacotherapeutic Options for Managing Neuropathic Pain: A Systematic Review and Meta-Analysis

Giulia Di Stefano et al. Pain Res Manag. .

Abstract

Despite an increasing number of available therapies, the treatment of neuropathic pain remains a major issue. Systematic reviews and meta-analyses indicate that only a minority of patients with neuropathic pain have an adequate response to pharmacological treatment and that most drugs have dose-limiting side effects. We conducted a systematic review and meta-analysis of randomised controlled trials published in the last five years. We searched for relevant papers within PubMed, EMBASE, the Cochrane Database of Systematic Reviews, and the Clinical Trials database (ClinicalTrials.gov). Two authors independently selected studies for inclusion, data extraction, and bias assessment. We identified 39 randomised controlled trials and included 16 in the meta-analysis. Trial outcomes were generally modest even for first-line drugs such as tricyclic antidepressants, serotonin-noradrenaline reuptake inhibitors, and gabapentinoids. Many drugs acting on new pain targets are currently under development. Clinical data are currently available for sodium channel isoform-specific antagonists, anti-nerve growth factor molecules, and fatty acid amide hydrolase inhibitors.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Flowchart of the search process.
Figure 2
Figure 2
Forest plots of randomised controlled trials included in the metanalysis. Each value is expressed as mean NNT (95% CI).
See this image and copyright information in PMC

References

    1. Bouhassira D., Attal N. Emerging therapies for neuropathic pain: new molecules or new indications for old treatments? Pain. 2018;159(3):576–582. doi: 10.1097/j.pain.0000000000001136. - DOI - PubMed
    1. Ciaramitaro P., Cruccu G., Cruccu G., et al. A delphi consensus statement of the neuropathic pain special interest group of the Italian neurological society on pharmacoresistant neuropathic pain. Neurological Sciences. 2019;40(7):1425–1431. doi: 10.1007/s10072-019-03870-y. - DOI - PubMed
    1. Finnerup N. B., Attal N., Haroutounian S., et al. Pharmacotherapy for neuropathic pain in adults: a systematic review and meta-analysis. The Lancet Neurology. 2015;14(2):162–173. doi: 10.1016/s1474-4422(14)70251-0. - DOI - PMC - PubMed
    1. Jadad A. R., Moore R. A., Carroll D., et al. Assessing the quality of reports of randomized clinical trials: is blinding necessary? Controlled Clinical Trials. 1996;17(1):1–12. doi: 10.1016/0197-2456(95)00134-4. - DOI - PubMed
    1. Borenstein M., Hedges L. V., Higgins J. P. T., Rothstein H. R. A basic introduction to fixed-effect and random-effects models for meta-analysis. Research Synthesis Methods. 2010;1(2):97–111. doi: 10.1002/jrsm.12. - DOI - PubMed

MeSH terms