医学
普瑞巴林
阿米替林
利多卡因
加巴喷丁
安慰剂
麻醉
不利影响
周围神经病变
糖尿病神经病变
神经病理性疼痛
内科学
糖尿病
内分泌学
病理
替代医学
作者
Robert Wolff,Małgorzata M Bała,Angela Wood,Alfons G.H. Kessels,Jos Kleijnen
出处
期刊:Schweizerische Medizinische Wochenschrift
日期:2010-06-05
被引量:69
标识
DOI:10.4414/smw.2010.12995
摘要
Several pharmacological treatments are used to manage painful diabetic peripheral neuropathy (DPN).To compare 5% lidocaine medicated plaster (5%LMP) for the relief of DPN with other relevant interventions and placebo.Six databases were searched up to June 2009. Quantitative methods for data synthesis were used and a network meta-analysis was conducted.Twenty-three studies (38 publications) were included. One study compared 5%LMP with pregabalin and indicated the non-inferiority of 5%LMP for pain reduction. DPN patients experienced a greater improvement in quality of life when using 5%LMP compared to pregabalin. Adverse events were significantly fewer in patients treated with 5%LMP. In the network meta-analysis, all interventions remained effective in comparison with placebo (mean difference in change of pain from baseline compared with placebo, amitriptyline: -12.58 [95% CI -16.66 to -8.50]; capsaicin: -9.40 [95% CI -13.92 to -4.88]; gabapentin: -10.22 [95% CI -17.25 to -3.19]; pregabalin: -10.53 [95% CI -14.74 to -6.32]; 5%LMP: -9.10 [95% CI -13.93 to -4.26]) and 5%LMP was comparable to all other interventions (amitriptyline: 3.48 [95% CI -0.78 to 7.75]; capsaicin: 0.31 [95% CI -4.39 to 5.00]; gabapentin: 1.12 [95% CI -6.02 to 8.27]; pregabalin: 1.43 [95% CI -2.96 to 5.83]).The results suggest that the effects in pain reduction of 5% lidocaine medicated plaster are comparable to those of amitriptyline, capsaicin, gabapentin and pregabalin. Topical agents such as 5%LMP may be associated with fewer and less clinically significant adverse events than is the case for systemic agents. However, the results are limited by the number and size of studies included, and thus further studies are needed.
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