REVISTA

Tratamiento tópico del dolor neuropático periférico: la evidencia

Valoración Valoración: 3 Estrellas

Descripción: Revisión basada en la evidencia de los métodos de tratamiento del dolor neuropático periférico

TITULO FUENTE ORIGINAL:

Topical Treatment of Peripheral Neuropathic Pain: Applying the Evidence

AUTORES:

Sommer C, Cruccu G

REVISTA ABREV.:

J Pain Symptom Manag

AÑO:

2017

REFERENCIA:

53(3):614-629

DOI:

10.1016/j.jpainsymman.2016.09.015

RESUMEN ORIGINAL:

Context. Patients with peripheral neuropathic pain (NP) may only achieve partial pain relief with currently recommended first-line oral treatments, which are also associated with systemic adverse events. Topical treatments are currently considered second- or third-line options, but a recent pharmacologic treatment algorithm has called for broader first-line use of these agents. This has... + Leer más

Context. Patients with peripheral neuropathic pain (NP) may only achieve partial pain relief with currently recommended first-line oral treatments, which are also associated with systemic adverse events. Topical treatments are currently considered second- or third-line options, but a recent pharmacologic treatment algorithm has called for broader first-line use of these agents. This has highlighted a need to communicate the benefits associated with topical agents, in particular around the efficacy, targeted local action, and limited systemic availability resulting in minimal systemic adverse events and drug-drug interactions.

Objectives. This review aims to evaluate the evidence base for topical therapies currently used to treat peripheral NP, discuss the evidence comparing these treatments head-to-head with oral standard of care, and evaluate how they fit into treatment regimens in the “real world.”

Methods. This is a narrative review.

Results. Two topical treatments are currently licensed: lidocaine 5% medicated plaster (post-herpetic neuralgia) and the capsaicin 8% patch (peripheral NP). When compared head to head with the oral standard of care (pregabalin), the lidocaine 5% medicated plaster provided similar relief of pain associated with post-herpetic neuralgia but did not meet the primary predefined criteria for noninferiority. The capsaicin 8% patch, however, demonstrated noninferior efficacy when compared head-to-head with pregabalin across a wide range of peripheral NP etiologies. Importantly, both treatments demonstrated effective pain relief without the systemic adverse events associated with oral therapies.

Conclusion. First-line use of topical agents may be of particular benefit in patients where the safety and tolerability of oral therapy is a concern.

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ENLACES DE INTERÉS

Enlace al pdf de acceso libre: : http://ac.els-cdn.com/S088539241631199X/1-s2.[...]

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