A prospective identification of neuropathic pain in specific chronic polyneuropathy syndromes and response to pharmacological therapy
Abstract
Although many pharmacological agents are used in the therapy of neuropathic pain (NeP) due to polyneuropathy (PN), there are limited comparison studies comparing these agents. We evaluated patients with PN and related NeP in a tertiary care neuromuscular clinic with prospective follow-up after 3 and 6 months for degree of NeP using a Visual Analog Score (VAS). Clinical response to specific open-label pharmacotherapies was measured and compared for those patients not receiving pharmacotherapy. The severity of PN was quantified by the Toronto Clinical Scoring System (TCSS), with patients classified according to etiology of PN. Of a total of 408 patients referred for diagnosis and/or management of PN, NeP was identified in 182 patients (45%). NeP was most prevalent in patients with alcohol-associated PN. Pharmacotherapy management was provided in 91% of cases at first visit, and for 87% of cases after 6 months of follow-up. There were no serious adverse events for patients related to any medications, which included gabapentinoids, tricyclic antidepressants, anticonvulsants, cannabinoids and topical agents. Prevalence of intolerable side effects was similar amongst groups of medications. Approximated numbers needed to treat were similar between different individual oral pharmacotherapies, trending towards greater treatment efficacy with combination therapy. NeP is common in patients with PN and frequently requires pharmacotherapy management, which may be more effective with combination therapy. Future studies assessing longer duration of follow-up and quality of life changes with the use of various pharmacotherapies for management of NeP due to PN will be important.
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Most forms of neuropathic pain had similar prevalence rates and responsiveness to the different pharmacotherapies evaluated.
“In this study, most forms of neuropathic pain had similar prevalence rates and responsiveness to the different pharmacotherapies evaluated.169”
From Cannabinoids as Pharmacotherapies for Neuropathic Pain: From the Bench to the Bedside (2009) · cites this paper as [169]
Intolerable side-effects were observed in all groups of patients receiving gabapentinoids, tricyclic antidepressants, anticonvulsants, cannabinoids, and topical agents.
“Intolerable side-effects were observed in all groups of patients receiving either gabapentainoids, tricyclic antidepressants, anticonvulsants, cannabinoids (nabilone or Sativex®) and topical agents).169”
From Cannabinoids as Pharmacotherapies for Neuropathic Pain: From the Bench to the Bedside (2009) · cites this paper as [169]
The presence of intolerable side-effects was similar amongst the different classes of medications.
“Notably, the presence of intolerable side-effects was similar amongst the different classes of medications.169”
From Cannabinoids as Pharmacotherapies for Neuropathic Pain: From the Bench to the Bedside (2009) · cites this paper as [169]
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Self-citation
- Authors
- Toth, C., & Au, S.
- Affiliations
- University of Calgary (CA)
- Corresponding author
- Toth, Cory
- Venue
- Pain
- Published
- 2008-09-15
- Volume
- 138
- Issue
- 3
- Pages
- 657-666
- ISSN
- 0304-3959 (ISSN-L)
- OpenAlex
- W1978853809
- Cited by
- 37
- References
- 48
- Citations by year
- 2025: 1 · 2024: 2 · 2022: 1 · 2020: 3 · 2018: 2 · 2017: 1 · 2016: 2 · 2015: 2 · 2014: 3 · 2013: 5 · 2012: 4
- FWCI
- 2.49
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Pain (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Pain Mechanisms and Treatments
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
- Health Sciences › Medicine › Neurology › Peripheral Neuropathies and Disorders
- Keywords
- neuropathic pain, chronic polyneuropathy, pharmacotherapy, gabapentinoids, tricyclic antidepressants, antiepileptic drugs, cannabinoids, topical analgesics, combination therapy, Toronto Clinical Scoring System, visual analogue scale, treatment response, adverse effects
- MeSH terms
- Aged, Analgesics, Female, Follow-Up Studies, Humans, Male, Middle Aged, Neuralgia, Pain Measurement, Polyneuropathies, Prospective Studies, Syndrome
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