Article

OBJECTIVE: To develop a scientifically sound and clinically relevant
evidence-based guideline for the treatment of painful diabetic neuropathy (PDN).
METHODS: We performed a systematic review of the literature from 1960 to August
2008 and classified the studies according to the American Academy of Neurology
classification of evidence scheme for a therapeutic article, and recommendations
were linked to the strength of the evidence. The basic question asked was: "What
is the efficacy of a given treatment (pharmacological: anticonvulsants,
antidepressants, opioids, others; and non-pharmacological: electrical
stimulation, magnetic field treatment, low-intensity laser treatment, Reiki
massage, others) to reduce pain and improve physical function and quality of life
(QOL) in patients with PDN?" RESULTS AND RECOMMENDATIONS: Pregabalin is
established as effective and should be offered for relief of PDN (Level A).
Venlafaxine, duloxetine, amitriptyline, gabapentin, valproate, opioids (morphine
sulphate, tramadol, and oxycodone controlled-release), and capsaicin are probably
effective and should be considered for treatment of PDN (Level B). Other
treatments have less robust evidence or the evidence is negative. Effective
treatments for PDN are available, but many have side effects that limit their
usefulness, and few studies have sufficient information on treatment effects on
function and QOL.
CI - Copyright (c) 2011 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS