Recent Developments in the Pharmacological Management of Neuropathic Pain

Attal N, Martinez V.  Recent Developments in the Pharmacological Management of Neuropathic Pain.  European Neurological Journal, June 2010; 2(1):  25-30


Review Article

Nadine Attal¹ and Valeria Martinez^1,2

Affiliations: ¹INSERM U987, Centre d’Evaluation et de Traitement de la Douleur, Hopital Ambroise Pare´, APHP, Boulogne-Billancourt, and Universite´ Versailles-Saint-Quentin, Versailles, France and ²Service d’anesthesie reanimation chirurgicale, Hopital Raymond Poincare´, APHP, Garches, France


ABSTRACT

The management of patients with chronic neuropathic pain (NP) is challenging, despite several attempts to develop a more rational therapeutic approach. Most randomized controlled trials (RCTs) of NP have been conducted on postherpetic neuralgia (PHN) and diabetic painful polyneuropathy (PPN). These placebo‐controlled trials mainly studied the effects of individual medications. Outcome measures were generally restricted to the global assessment of pain and the quality of pain was seldom taken into account. However, new studies have recently appeared that may contribute to revising this statement. Several RCTs have been performed on indications that have been neglected thus far, such as central pain, painful radiculopathies, and post‐traumatic NP; combination studies and head‐to‐head comparative studies have appeared, although these are scarce; recent studies have also used a more comprehensive assessment of patients, including pain quality. The present review aims at emphasizing new developments in the therapeutic management of NP, particularly with regard to these new clinical studies. Potential emerging drug treatments will also be described.

Keywords: neuropathic pain, randomized controlled trials, systematic review, emerging treatments
Correspondence: Nadine Attal, INSERM U 987, Centre d'Evaluation et de Traitement de la Douleur, Hôpital Ambroise Paré, APHP, Boulogne‐Billancourt, France. Tel: 0033149095946; Fax: 0033149094435; e‐mail: nadine.attal@apr.aphp.fr