REVISTA DESTACADA

Eficacia de la palmitoil-etanolamida en el dolor crónico

Valoración Valoración: 3 Estrellas

Descripción: El lídido natural palmitoiletanolamida, empleado como en la dieta como nutracéutico, parece ser eficaz en el manejo del dolor crónico.

TITULO FUENTE ORIGINAL:

Palmitoylethanolamide, a Special Food for Medical Purposes, in the Treatment of Chronic Pain: A Pooled Data Meta-analysis

AUTORES:

Paladini A, Fusco M, Cenacchi T, Schievano C, Piroli A, Varrassi G

REVISTA ABREV.:

Pain Physician

AÑO:

2016

REFERENCIA:

19(2):11-24

RESUMEN ORIGINAL:

BACKGROUND: A growing body of evidence suggests that neuroinflammation, which is characterized by infiltration of immune cells, activation of mast cells and glial cells, and production of inflammatory mediators in the peripheral and central nervous systems, has an important role in the induction and maintenance of chronic pain. These findings support the notion that new therapeutic... + Leer más

BACKGROUND: A growing body of evidence suggests that neuroinflammation, which is characterized by infiltration of immune cells, activation of mast cells and glial cells, and production of inflammatory mediators in the peripheral and central nervous systems, has an important role in the induction and maintenance of chronic pain. These findings support the notion that new therapeutic opportunities for chronic pain might be based on anti-inflammatory and pro-resolving mediators that act on immune cells, in particular mast cells and glia, to mitigate or abolish neuroinflammation. Among anti-inflammatory and pro-resolving lipid mediators, palmitoylethanolamide (PEA) has been reported to down-modulate mast cell activation and to control glial cell behaviors.
OBJECTIVE: The aim of this study was to perform a pooled meta-analysis to evaluate the efficacy and safety of micronized and ultra-micronized palmitoylethanolamide (PEA) on pain intensity in patients suffering from chronic and/or neuropathic pain.
STUDY DESIGN: Pooled data analysis consisting of double-blind, controlled, and open-label clinical trials.
METHODS: Double-blind, controlled, and open-label clinical trials were selected consulting the PubMed, Google Scholar, and Cochrane databases, and proceedings of neuroscience meetings. The terms chronic pain, neuropathic pain, and micronized and ultra-micronized PEA were used for the search. Selection criteria included availability of raw data and comparability between tools used to diagnose and assess pain intensity. Raw data obtained by authors were pooled in one database and analyzed by the Generalized Linear Mixed Model. The changes in pain over time, measured by comparable tools, were also assessed by linear regression post-hoc analysis and the Kaplan-Meier estimate. Twelve studies were included in the pooled meta-analysis, 3 of which were double-blind trials comparing active comparators vs placebo, 2 were open-label trials vs standard therapies, and 7 were open-label trials without comparators.
RESULTS: Results showed that PEA elicits a progressive reduction of pain intensity significantly higher than control. The magnitude of reduction equals 1.04 points every 2 weeks with a 35% response variance explained by the linear model. In contrast, in the control group pain, reduction intensity equals 0.20 points every 2 weeks with only 1% of the total variance explained by the regression. The Kaplan-Meier estimator showed a pain score = 3 in 81% of PEA treated patients compared to only 40.9% in control patients by day 60 of treatment. PEA effects were independent of patient age or gender, and not related to the type of chronic pain.
LIMITATIONS: Noteworthy, serious adverse events related to PEA were not registered and/or reported in any of the studies.
CONCLUSION: These results confirm that PEA might represent an exciting, new therapeutic strategy to manage chronic and neuropathic pain associated with neuroinflammation.

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COMENTARIO DE IGNACIO, ?LVAREZ G?MEZ DE SEGURA

La palmitoiletanolamida (o PEA) es una amida presente en alimentos o que se sintetiza por el organismo a partir de etanolamina y el ácido palmítico contenidos en la dieta. Este lípido endógeno destaca por sus efectos moduladores del dolor y la inflamación. Aunque se conocen estos efectos desde hace 50 años,... + Leer más

La palmitoiletanolamida (o PEA) es una amida presente en alimentos o que se sintetiza por el organismo a partir de etanolamina y el ácido palmítico contenidos en la dieta. Este lípido endógeno destaca por sus efectos moduladores del dolor y la inflamación. Aunque se conocen estos efectos desde hace 50 años, recientemente es cuando han aparecido evidencias que apoyan su uso terapéutico en el dolor crónico. Esta revisión sistemática o metaanálisis identifica 12 ensayos clínicos relevantes que evalúan esta sustancia. La misma se suministra en cápsulas con PEA purificado disponibles en farmacias, aunque realmente se considera un nutracéutico. Las fuentes naturales de PEA son los aceites vegetales, la yema de huevo, las semillas de soja o los guisantes. Los autores consideran que el PEA promueve una reducción progresiva de los síntomas de dolor sin que se hayan observado efectos adversos. Los autores de este estudio de estudios consideran que esta estrategia terapéutica ‘dietética’ supone una oportunidad nueva de manejo del dolor crónico. Ello implica que el empleo de PEA como complemento de la dieta aliviaría, pero no necesariamente eliminaría el dolor crónico.

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ENLACES DE INTERÉS

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