The economic burden of neuropathic pain in Canada

Tarride, Jean‐Éric; Jp, Collet; Choinière, Manon; Rousseau, Catherine; Gordon, A.

doi:10.3111/200609055068

Cited by 29 publications

(25 citation statements)

References 4 publications

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“…17 Moreover, a Canadian study on the economic burden of neuropathic pain from 2006 showed that at least 45% of participants received combination therapy with 2 or more drugs. 35 More than a decade ago, use of a mechanism-based approach in the pharmacological treatment of neuropathic pain was suggested. 23,38 Neuropathic pain phenotypes have been described from symptoms, signs, and quantitative sensory testing (QST).…”

Section: Introductionmentioning

confidence: 99%

Imipramine and pregabalin combination for painful polyneuropathy

Holbech

Bach

Finnerup

et al. 2015

Pain

110

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Monotherapy with first-line drugs for neuropathic pain often fails to provide sufficient pain relief or has unacceptable side effects because of the need for high doses. The aim of this trial was to test whether the combination of imipramine and pregabalin in moderate doses would relieve pain more effectively than monotherapy with either of the drugs. This was a randomized, double-blind, placebo-controlled, crossover, multicenter trial consisting of four 5-week treatment periods in patients with painful polyneuropathy. Treatment arms were imipramine 75 mg/d vs pregabalin 300 mg/d vs combination therapy vs placebo. Patients with polyneuropathy and symptoms for more than 6 months, age 20 to 85 years, pain intensity ≥4 on a 0- to 10-point numeric rating scale (NRS) and pain at least 4 days a week were included in the trial. A total of 262 patients were screened for participation, 73 patients were randomized, and 69 patients were included in the data analysis. The effect on average pain in comparison with placebo was: combination (-1.67 NRS points, P < 0.001), imipramine (-1.08 NRS points, P < 0.001), and pregabalin (-0.48 NRS points, P = 0.03). The combination therapy had significantly lower pain scores than both monotherapies: combination vs imipramine (P = 0.009), combination vs pregabalin (P < 0.001). During combination therapy, the dropout rate was higher and the patients reported a higher rate and severity of side effects. Combination of moderate doses of the tricyclic antidepressant imipramine and pregabalin could be considered as an alternative to high-dosage monotherapy. However, the trial also emphasized that balance between efficacy and safety is an issue.

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Section: Introductionmentioning

confidence: 99%

Imipramine and pregabalin combination for painful polyneuropathy

Holbech

Bach

Finnerup

et al. 2015

Pain

110

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“…Satisfactory relief of neuropathic pain is achieved in less than 30% of these patients, with consequent significant detriment to the quality of life of the remaining individuals (Barrett et al, 2007). In addition, the disorder represents a significant economic burden to health-care systems (Tarride et al, 2006;Dworkin et al, 2010).…”

Section: Introductionmentioning

confidence: 99%

A genome‐wide association study suggests an association of Chr8p21.3 (GFRA2) with diabetic neuropathic pain

Wang

Deshmukh

Zuydam

et al. 2015

European Journal of Pain

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BackgroundNeuropathic pain, caused by a lesion or a disease affecting the somatosensory system, is one of the most common complications in diabetic patients. The purpose of this study is to identify genetic factors contributing to this type of pain in a general diabetic population.MethodWe accessed the Genetics of Diabetes Audit and Research Tayside (GoDARTS) datasets that contain prescription information and monofilament test results for 9439 diabetic patients, among which 6927 diabetic individuals were genotyped by Affymetrix SNP6.0 or Illumina OmniExpress chips. Cases of neuropathic pain were defined as diabetic patients with a prescription history of at least one of five drugs specifically indicated for the treatment of neuropathic pain and in whom monofilament test result was positive for sensory neuropathy in at least one foot. Controls were individuals who did not have a record of receiving any opioid analgesics. Imputation of non‐genotyped SNPs was performed by IMPUTE2, with reference files from 1000 Genomes Phase I datasets.ResultsAfter data cleaning and relevant exclusions, imputed genotypes of 572 diabetic neuropathic pain cases and 2491 diabetic controls were used in the Fisher's exact test. We identified a cluster in the Chr8p21.3, next to GFRA2 with a lowest p‐value of 1.77 × 10−7 at rs17428041. The narrow‐sense heritability of this phenotype was 11.00%.ConclusionThis genome‐wide association study on diabetic neuropathic pain suggests new evidence for the involvement of variants near GFRA2 with the disorder, which needs to be verified in an independent cohort and at the molecular level.

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“…The course of NP can be episodic and recurrent, slowly progressing over many years, or it can quickly become severe and debilitating. Both direct and indirect costs of NP to society are substantial [10-14]. The consequences to the individual patient profoundly impair emotional and physical functioning with consequences such as movement limitation, an inability to perform major activities of daily living, needing help for personal care, frequent use of health care services, and work productivity losses [10,11,15,16].…”

Section: Introductionmentioning

confidence: 99%

Are treatment benefits in neuropathic pain reflected in the self assessment of treatment questionnaire?

Holmström

Stoker

Wyrwich³

et al. 2013

Health and Quality of Life Outcomes

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Background/objectiveThe Self Assessment of Treatment (SAT) questionnaire was developed to reflect key patient reported outcomes of Neuropathic Pain (NP) treatments. This study aimed to understand how patients perceived the relevance and ease of understanding of the questions in the SAT and to recommend modifications based on patient and clinician interviews.MethodsSemi-structured interviews were conducted with clinicians and NP patients to provide information regarding treatment attributes and the impact of pain. Patients were debriefed on the SAT, a 5-item scale evaluating pain, activity level, quality of life (QoL) and satisfaction with treatment (recommend treatment and undergo treatment again). The SAT has a recall period reflecting back to the start of treatment. The qualitative analysis software ATLAS.ti 5.0 was used to analyze patient transcripts. Changes to the SAT were integrated into the questionnaire for a second round of debriefing interviews.ResultsThree NP clinicians and 44 patients (20 painful diabetic neuropathy, 16 HIV-associated neuropathy and 8 post herpetic neuralgia) with a mean age of 60.3 (12.3) years and an even gender distribution were interviewed. Patient treatment experience included anticonvulsants (73%), antidepressants (34%), opioids (25%), and topical medications (41%). Pain descriptors and treatment attributes were similar across the three NP groups. Pain relief was judged the most important treatment attribute, followed by ability to undertake activities. Sleep improvement was another important attribute. Activity limitations and QOL were perceived as too broad and non-specific, and were split into 3 concepts each (activity limitations was split into self care, daily and physical activities and QOL was split into sleep, emotions, and social function). A 7-day recall period was introduced. The item stem and response options were made consistent, and a baseline and follow-up questionnaires were developed (except for the satisfaction items) to enable monitoring onset of treatment benefit and change over time.ConclusionsThe content validity of the revised SAT was improved by the qualitative research, and NP treatment benefits are reflected in a more consistent fashion by the changes. Baseline and follow-up versions make it possible to perform assessments of change over time.

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The economic burden of neuropathic pain in Canada

Cited by 29 publications

References 4 publications

Imipramine and pregabalin combination for painful polyneuropathy

Imipramine and pregabalin combination for painful polyneuropathy

A genome‐wide association study suggests an association of Chr8p21.3 (GFRA2) with diabetic neuropathic pain

Are treatment benefits in neuropathic pain reflected in the self assessment of treatment questionnaire?

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