Abstract | BACKGROUND:
Neuropathic pain (NeP), redefined as pain caused by a lesion or a disease of the somatosensory system, is a disabling condition that affects approximately two million Canadians. OBJECTIVE: To review the randomized controlled trials (RCTs) and systematic reviews related to the pharmacological management of NeP to develop a revised evidence-based consensus statement on its management. METHODS: RCTs, systematic reviews and existing guidelines on the pharmacological management of NeP were evaluated at a consensus meeting in May 2012 and updated until September 2013. Medications were recommended in the consensus statement if their analgesic efficacy was supported by at least one methodologically sound RCT (class I or class II) showing significant benefit relative to placebo or another relevant control group. Recommendations for treatment were based on the degree of evidence of analgesic efficacy, safety and ease of use. RESULTS: CONCLUSIONS: These guidelines provide an updated, stepwise approach to the pharmacological management of NeP. Treatment should be individualized for each patient based on efficacy, side-effect profile and drug accessibility, including cost. Additional studies are required to examine head-to-head comparisons among analgesics, combinations of analgesics, long-term outcomes and treatment of pediatric, geriatric and central NeP.
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Authors | Dwight Moulin, Aline Boulanger, A J Clark, Hance Clarke, Thuan Dao, G A Finley, Andrea Furlan, Ian Gilron, Allan Gordon, Patricia K Morley-Forster, Barry J Sessle, Pamela Squire, Jennifer Stinson, Paul Taenzer, Ana Velly, Mark A Ware, Erica L Weinberg, Owen D Williamson, Canadian Pain Society |
Journal | Pain research & management
(Pain Res Manag)
2014 Nov-Dec
Vol. 19
Issue 6
Pg. 328-35
ISSN: 1918-1523 [Electronic] United States |
PMID | 25479151
(Publication Type: Consensus Development Conference, Journal Article, Practice Guideline, Research Support, Non-U.S. Gov't)
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Chemical References |
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Topics |
- Analgesics
(therapeutic use)
- Canada
- Chronic Pain
(drug therapy)
- Humans
- Neuralgia
(drug therapy)
- Pain Management
(methods)
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