Impact of etiology and duration of pain on pharmacological treatment effects in painful polyneuropathy

Publication: Research - peer-reviewJournal article

Standard

Impact of etiology and duration of pain on pharmacological treatment effects in painful polyneuropathy. / Sindrup, Søren Hein; Holbech, J.; Demant, Dyveke T; Finnerup, Nanna Brix; Bach, Flemming Winther; Jensen, Troels Staehelin.

In: European journal of pain (London, England), Vol. 21, No. 8, 09.2017, p. 1443-1450.

Publication: Research - peer-reviewJournal article

Harvard

Sindrup, SH, Holbech, J, Demant, DT, Finnerup, NB, Bach, FW & Jensen, TS 2017, 'Impact of etiology and duration of pain on pharmacological treatment effects in painful polyneuropathy' European journal of pain (London, England), vol 21, no. 8, pp. 1443-1450. DOI: 10.1002/ejp.1048

APA

Sindrup, S. H., Holbech, J., Demant, D. T., Finnerup, N. B., Bach, F. W., & Jensen, T. S. (2017). Impact of etiology and duration of pain on pharmacological treatment effects in painful polyneuropathy. European journal of pain (London, England), 21(8), 1443-1450. DOI: 10.1002/ejp.1048

CBE

Sindrup SH, Holbech J, Demant DT, Finnerup NB, Bach FW, Jensen TS. 2017. Impact of etiology and duration of pain on pharmacological treatment effects in painful polyneuropathy. European journal of pain (London, England). 21(8):1443-1450. Available from: 10.1002/ejp.1048

MLA

Sindrup, Søren Hein et al."Impact of etiology and duration of pain on pharmacological treatment effects in painful polyneuropathy". European journal of pain (London, England). 2017, 21(8). 1443-1450. Available: 10.1002/ejp.1048

Vancouver

Sindrup SH, Holbech J, Demant DT, Finnerup NB, Bach FW, Jensen TS. Impact of etiology and duration of pain on pharmacological treatment effects in painful polyneuropathy. European journal of pain (London, England). 2017 Sep;21(8):1443-1450. Available from, DOI: 10.1002/ejp.1048

Author

Sindrup, Søren Hein; Holbech, J.; Demant, Dyveke T; Finnerup, Nanna Brix; Bach, Flemming Winther; Jensen, Troels Staehelin / Impact of etiology and duration of pain on pharmacological treatment effects in painful polyneuropathy.

In: European journal of pain (London, England), Vol. 21, No. 8, 09.2017, p. 1443-1450.

Publication: Research - peer-reviewJournal article

Bibtex

@article{c5ec1cc45a86467999ea1fc5080d2302,
title = "Impact of etiology and duration of pain on pharmacological treatment effects in painful polyneuropathy",
abstract = "Background: The pharmacological treatments for painful polyneuropathy have not changed much for more than a decade, and less than half of the patients obtain adequate pain relief with first line treatments. Therefore, patient-specific factors which could predict drug response are searched for.Methods: Data from 4 published, randomized, controlled trials of drugs in painful polyneuropathy to see if diabetic etiology and duration of neuropathic pain had an impact on drug efficacy were analysed. The studies had a crossover design, and had nearly similar outcome recordings as well as a thorough baseline registration of symptoms, signs and quantitative sensory testing. 244 patient records of drug effect distributed over treatments with three antidepressants (imipramine, venlafaxine, escitalopram) and two anticonvulsants (pregabalin, oxcarbazepine) were analysed.Results: Diabetes as etiology of polyneuropathy had no impact on the effect of antidepressants (imipramine, venlafaxine, escitalopram), but there was a significant interaction with treatment effect on anticonvulsants with better effects in diabetics (0.86 NRS points, p = 0.021) with most pronounced interaction for oxcarbazepine (1.47 NRS points, p = 0.032). There was an interaction between duration of neuropathic pain and treatment with antidepressants with better effect with duration less than 3 years (0.62 NRS points, p = 0.036), whereas anticonvulsants tended to work best with duration of pain for more than 3 years.Conclusion: Despite the small sample size and limited number of drugs included this study suggests that diabetic etiology of polyneuropathy may impact on the efficacy of anticonvulsants, and duration of neuropathic pain may impact on the efficacy of antidepressants.Significance: This study found that duration of pain appears to have an impact on the effect of antidepressants in neuropathic pain and that diabetes as etiology for painful polyneuropathy appears to influence pain relief obtained with anticonvulsants.",
keywords = "Journal Article",
author = "Sindrup, {Søren Hein} and J. Holbech and Demant, {Dyveke T} and Finnerup, {Nanna Brix} and Bach, {Flemming Winther} and Jensen, {Troels Staehelin}",
note = "© 2017 European Pain Federation - EFIC®.",
year = "2017",
month = "9",
doi = "10.1002/ejp.1048",
volume = "21",
pages = "1443--1450",
journal = "European Journal of Pain",
issn = "1090-3801",
publisher = "JohnWiley & Sons Ltd.",
number = "8",

}

RIS

TY - JOUR

T1 - Impact of etiology and duration of pain on pharmacological treatment effects in painful polyneuropathy

AU - Sindrup,Søren Hein

AU - Holbech,J.

AU - Demant,Dyveke T

AU - Finnerup,Nanna Brix

AU - Bach,Flemming Winther

AU - Jensen,Troels Staehelin

N1 - © 2017 European Pain Federation - EFIC®.

PY - 2017/9

Y1 - 2017/9

N2 - Background: The pharmacological treatments for painful polyneuropathy have not changed much for more than a decade, and less than half of the patients obtain adequate pain relief with first line treatments. Therefore, patient-specific factors which could predict drug response are searched for.Methods: Data from 4 published, randomized, controlled trials of drugs in painful polyneuropathy to see if diabetic etiology and duration of neuropathic pain had an impact on drug efficacy were analysed. The studies had a crossover design, and had nearly similar outcome recordings as well as a thorough baseline registration of symptoms, signs and quantitative sensory testing. 244 patient records of drug effect distributed over treatments with three antidepressants (imipramine, venlafaxine, escitalopram) and two anticonvulsants (pregabalin, oxcarbazepine) were analysed.Results: Diabetes as etiology of polyneuropathy had no impact on the effect of antidepressants (imipramine, venlafaxine, escitalopram), but there was a significant interaction with treatment effect on anticonvulsants with better effects in diabetics (0.86 NRS points, p = 0.021) with most pronounced interaction for oxcarbazepine (1.47 NRS points, p = 0.032). There was an interaction between duration of neuropathic pain and treatment with antidepressants with better effect with duration less than 3 years (0.62 NRS points, p = 0.036), whereas anticonvulsants tended to work best with duration of pain for more than 3 years.Conclusion: Despite the small sample size and limited number of drugs included this study suggests that diabetic etiology of polyneuropathy may impact on the efficacy of anticonvulsants, and duration of neuropathic pain may impact on the efficacy of antidepressants.Significance: This study found that duration of pain appears to have an impact on the effect of antidepressants in neuropathic pain and that diabetes as etiology for painful polyneuropathy appears to influence pain relief obtained with anticonvulsants.

AB - Background: The pharmacological treatments for painful polyneuropathy have not changed much for more than a decade, and less than half of the patients obtain adequate pain relief with first line treatments. Therefore, patient-specific factors which could predict drug response are searched for.Methods: Data from 4 published, randomized, controlled trials of drugs in painful polyneuropathy to see if diabetic etiology and duration of neuropathic pain had an impact on drug efficacy were analysed. The studies had a crossover design, and had nearly similar outcome recordings as well as a thorough baseline registration of symptoms, signs and quantitative sensory testing. 244 patient records of drug effect distributed over treatments with three antidepressants (imipramine, venlafaxine, escitalopram) and two anticonvulsants (pregabalin, oxcarbazepine) were analysed.Results: Diabetes as etiology of polyneuropathy had no impact on the effect of antidepressants (imipramine, venlafaxine, escitalopram), but there was a significant interaction with treatment effect on anticonvulsants with better effects in diabetics (0.86 NRS points, p = 0.021) with most pronounced interaction for oxcarbazepine (1.47 NRS points, p = 0.032). There was an interaction between duration of neuropathic pain and treatment with antidepressants with better effect with duration less than 3 years (0.62 NRS points, p = 0.036), whereas anticonvulsants tended to work best with duration of pain for more than 3 years.Conclusion: Despite the small sample size and limited number of drugs included this study suggests that diabetic etiology of polyneuropathy may impact on the efficacy of anticonvulsants, and duration of neuropathic pain may impact on the efficacy of antidepressants.Significance: This study found that duration of pain appears to have an impact on the effect of antidepressants in neuropathic pain and that diabetes as etiology for painful polyneuropathy appears to influence pain relief obtained with anticonvulsants.

KW - Journal Article

U2 - 10.1002/ejp.1048

DO - 10.1002/ejp.1048

M3 - Journal article

VL - 21

SP - 1443

EP - 1450

JO - European Journal of Pain

T2 - European Journal of Pain

JF - European Journal of Pain

SN - 1090-3801

IS - 8

ER -