Pharmacological interventions for painful diabetic neuropathy: Comparative analysis using network meta-analysis

• Published in: Journal of diabetes investigation Vol. 6; no. 6; pp. 620 - 622
• Main Author: Yasuda, Hitoshi
• Format: Journal Article
• Language: English
• Published: Japan Blackwell Publishing Ltd 01.11.2015; John Wiley & Sons, Inc; John Wiley & Sons, Ltd
• Subjects: Analgesics; Antidepressants; Bias; Clinical trials; Commentaries; Diabetes; Diabetes mellitus; Diabetic neuropathy; Narcotics; Pain; Paresthesia; Quality of life; Serotonin; Systematic review
• ISSN: 2040-1116; 2040-1124
• DOI: 10.1111/jdi.12354

[...]as the authors concluded, the current evidence about the comparative effectiveness of pharmacological interventions for PDN is still limited. [...]network meta‐analysis does not enable indirect comparison satisfactorily if the number of clinical trials is not large and the quality of RCTs is not high. [...]the authors stated in the methods of their manuscript that they developed a list of drugs commonly used in the USA and Europe for diabetic neuropathy. [...]all RCTs of ARIs have not aimed at alleviation of pain symptoms as the primary end‐point for the clinical trials. [...]more than half of the patients who were enrolled in RCTs did not have painful symptoms, but a variety of sensory symptoms, which included numbness, paresthesia and dysesthesia. The authors assessed efficacy at the furthest of multiple time‐points separately within 3 months (short‐time effect) and longer than 3 months (long‐time effect), although the number of long‐term RCTs was relatively few. Because most of the RCTs were carried out for 3 months or less, it remains to be clear how long the beneficial effect continues with or without adverse effects, even if the given drugs have been shown to be effective for a 3‐month observation period.