Oxcarbazepine in painful diabetic neuropathy: a randomized, placebo‐controlled study

Dogra, Sunil; Beydoun, Said R.; Mazzola, Jennifer L.; Hopwood, Margaret B.; Wan, Ying

doi:10.1016/j.ejpain.2004.11.006

Cited by 167 publications

(82 citation statements)

References 39 publications

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“…18 -20 Two studies showed no benefit, 18,20 but a third showed a moderate benefit-17% more patients on oxcarbazepine had a Ͼ50% pain reduction compared to placebo, with an NNT of 6.023. 19 The study showing a positive response had a slightly higher completion rate (73% 19 compared to 67%). 20 Short Form-Quality of Life (SF-QOL) scores were not improved.…”

Section: Analysis Of Evidence In Patients With Pdnmentioning

confidence: 99%

Evidence-based guideline: Treatment of painful diabetic neuropathy [RETIRED]

et al. 2011

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Objective: To develop a scientifically sound and clinically relevant evidence-based guideline for the treatment of painful diabetic neuropathy (PDN). Methods:We performed a systematic review of the literature from 1960 to August 2008 and classified the studies according to the American Academy of Neurology classification of evidence scheme for a therapeutic article, and recommendations were linked to the strength of the evidence. The basic question asked was: "What is the efficacy of a given treatment (pharmacologic: anticonvulsants, antidepressants, opioids, others; and nonpharmacologic: electrical stimulation, magnetic field treatment, low-intensity laser treatment, Reiki massage, others) to reduce pain and improve physical function and quality of life (QOL) in patients with PDN?" Results and Recommendations:Pregabalin is established as effective and should be offered for relief of PDN (Level A). Venlafaxine, duloxetine, amitriptyline, gabapentin, valproate, opioids (morphine sulfate, tramadol, and oxycodone controlled-release), and capsaicin are probably effective and should be considered for treatment of PDN (Level B). Other treatments have less robust evidence or the evidence is negative. Effective treatments for PDN are available, but many have side effects that limit their usefulness, and few studies have sufficient information on treatment effects on function and QOL. Neurology Diabetic sensorimotor polyneuropathy represents a diffuse symmetric and length-dependent injury to peripheral nerves that has major implications on quality of life (QOL), morbidity, and costs from a public health perspective.1,2 Painful diabetic neuropathy (PDN) affects 16% of patients with diabetes, and it is frequently unreported (12.5%) and more frequently untreated (39%).3 PDN presents an ongoing management problem for patients, caregivers, and physicians. There are many treatment options available, and a rational approach to treating the patient with PDN requires an understanding of the evidence for each intervention.This guideline addresses the efficacy of pharmacologic and nonpharmacologic treatments to reduce pain and improve physical function and QOL in patients with PDN. The pharmacologic agents reviewed include anticonvulsants, antidepressants, opioids, anti-arrhythmics, cannabinoids, aldose reductase inhibitors, protein kinase

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Section: Analysis Of Evidence In Patients With Pdnmentioning

confidence: 99%

Evidence-based guideline: Treatment of painful diabetic neuropathy [RETIRED]

et al. 2011

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“…121,122 Zonisamide, levetiracetam, and tiagabine At this time, no significant studies have been published reporting the benefit of these agents for chronic painful conditions.…”

Section: Oxcarbazepinementioning

confidence: 99%

Use of Antiepileptic Drugs for Nonepileptic Conditions: Psychiatric Disorders and Chronic Pain

2007

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Summary: Antiepileptic drugs (AEDs) are commonly utilized for nonepileptic conditions, including various psychiatric disorders and pain syndromes. Evidence for their benefit in these nonepileptic conditions varies widely among different drugs, but there is, in general, a paucity of published multicenter randomized double-blind trials. Variable levels of evidence suggest that lamotrigine and the vagal nerve stimulator have antidepressant properties. Carbamazepine, valproate, lamotrigine, and oxcarbazepine appear to have mood stabilizing properties while gabapentin, pregabalin, and tiagabine have anxiolytic benefits. Barbiturates, topiramate, and possibly phenytoin may precipitate or exacerbate depression. Underlying depression and anxiety symptoms may be exacerbated by levetiracetam, while psychotic symptoms have rarely been reported with topiramate, levetiracetam, and zonisamide. Pregabalin, gabapentin, carbamazepine, and oxcarbazepine have been used to treat neuropathic pain such as postherpetic neuralgia, and diabetic polyneuropathy. Topiramate and divalproex sodium have utility in the prophylaxis or acute treatment of migraine. Further rigorous studies are needed to clarify the utility of AEDs in nonepileptic conditions.

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“…61 Oxcarbazepine, a newer anticonvulsant structurally related to carbamazepine, may also be useful; however, only one RCT (in diabetic peripheral neuropathy) has been published. 85 Gabapentin, an α-2-delta subunit voltage-gated calciumchannel antagonist, 86 has repeatedly demonstrated analgesic Pregabalin is a gabapentin analogue with a similar mechanism, higher calcium-channel affinity and better bioavailability. 60,87 Pregabalin was superior to placebo in several RCTs in diabetic peripheral neuropathy and postherpetic neuralgia (NNT = 4.2).…”

Section: Anticonvulsantsmentioning

confidence: 99%