World Health Organization essential medicines lists

Kamerman, Peter R.; Wadley, Antonia L.; Davis, Karen D.; Hietaharju, Aki; Jain, Pranay; Kopf, Andreas; Meyer, Ana-Claire; Raja, Srinivasa N.; Rice, Andrew S.C.; Smith, Blair H.; Treede, R.‐D.; Wiffen, Philip J

doi:10.1097/01.j.pain.0000460356.94374.a1

Cited by 42 publications

(30 citation statements)

References 21 publications

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“…On the other hand, tricyclic antidepressants have been shown to have the highest efficacy profile and recent meta-analyses 13 and are widely available worldwide. 21 We have also assessed pain treatment profile and efficacy at visit 2. We have no information on the pharmacological treatment patients were already on during visit 1.…”

Section: Discussionmentioning

confidence: 99%

Neuropathic pain in leprosy: symptom profile characterization and comparison with neuropathic pain of other etiologies

Raicher

Stump

Harnik

et al. 2018

PR9

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Introduction: Previous studies reported a high prevalence of neuropathic pain in leprosy, being especially present in “pharmacologically cured” patients. The presence of neuropathic pain in leprosy poses a supplementary burden in patient's quality of life, daily activities, and mood. Objectives: The aim of this study was to assess whether neuropathic pain in leprosy has similar symptom profile as neuropathic pain of other etiologies and to retrospectively assess the efficacy of neuropathic pain medications regularly prescribed to leprosy. Methods: Leprosy and nonleprosy patients had their neuropathic pain characterized by the neuropathic pain symptom inventory (NPSI, ranges from 0 to 100, with 100 being the maximal neuropathic pain intensity) in a first visit. In a second visit, leprosy patients who had significant pain and received pharmacological treatment in the first evaluation were reassessed (NPSI) and had their pain profile and treatment response further characterized, including information on drugs prescribed for neuropathic pain and their respective pain relief. Results: The pain characteristics based on NPSI did not significantly differ between leprosy and nonleprosy neuropathic pain patients in visit 1 after correction for multiple analyses, and cluster analyses confirmed these findings (ie, no discrimination between leprosy and nonleprosy groups; Pearson χ2 = 0.072, P = 0.788). The assessment of pain relief response and the drugs taken by each patient, linear regression analysis showed that amitriptyline, when effective, had the highest percentage of analgesic relief. Conclusions: Neuropathic pain in leprosy is as heterogeneous as neuropathic pain of other etiologies, further supporting the concept that neuropathic pain is a transetiological entity. Neuropathic pain in leprosy may respond to drugs usually used to control pain of neuropathic profile in general, and amitriptiline may constitute a potential candidate drug for future formal clinical trials aimed at controlling neuropathic pain in leprosy.

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Section: Discussionmentioning

confidence: 99%

Neuropathic pain in leprosy: symptom profile characterization and comparison with neuropathic pain of other etiologies

Raicher

Stump

Harnik

et al. 2018

PR9

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“…We believe that our and others’ failure to show efficacy for amitriptyline in a variety of different settings is of significant concern given that amitriptyline is recommended by several agencies [ 17 , 18 ] for the treatment of painful HIV-SN, and is the only drug recommended first line for the treatment of neuropathic pain that is included on the WHO master list of essential medicines and the essential medicines lists of most developing countries [ 2 , 14 ]. Further research is urgently required to understand the mechanisms and pathophysiology of HIV-SN and to develop alternative treatment modalities and evaluate preventative strategies.…”

Section: Discussionmentioning

confidence: 99%

“…Amitriptyline, is a tricyclic antidepressant that is effective in treating neuropathic pain [ 13 ], and is widely available in developing countries [ 2 , 14 ]. However, two published trials found amitriptyline was no more effective than placebo for the treatment of painful HIV-SN [ 15 , 16 ].…”

Section: Introductionmentioning

confidence: 99%

Randomized, Double-Blind, Crossover Trial of Amitriptyline for Analgesia in Painful HIV-Associated Sensory Neuropathy

et al. 2015

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We conducted a randomized, double-blind, placebo-controlled, crossover study at a single center in South Africa, to ascertain whether amitriptyline is an effective analgesic for painful HIV-associated sensory neuropathy of moderate to severe intensity in: i) antiretroviral drug naive individuals, and ii) antiretroviral drug users. 124 HIV-infected participants (antiretroviral drug naive = 62, antiretroviral drug users = 62) who met the study criteria for painful HIV-associated sensory neuropathy were randomized to once-daily oral amitriptyline (titrated to a median: interquartile range of 50: 25-50 mg) or placebo for six weeks, followed by a three-week washout period and subsequent treatment crossover. The primary outcome measure was change from baseline in worst pain intensity of the feet (measured by participant self-report using an 11-point numerical pain rating scale) after six weeks of treatment. 122 of 124 participants completed all study visits and were included in the analysis of the primary outcome. In the antiretroviral drug-naive group (n = 61) there was no significant difference in the mean change in pain score from baseline after six weeks of treatment with placebo or amitriptyline [amitriptyline: 2.8 (SD 3.3) vs. placebo: 2.8 (3.4)]. Similarly, there was no significant difference in the change in pain score after six weeks of treatment with placebo or amitriptyline in the antiretroviral drug-user group (n = 61) [amitriptyline: 2.7 (3.3) vs. placebo: 2.1 (2.8)]. Controlling for period effects and treatment order effects did not alter the outcome of the analyses. Nor did analyzing the intention-to-treat cohort (missing data interpolated using baseline observation carried forward) alter the outcome of the analyses. In summary, amitriptyline, at the doses used here, was no more effective than an inactive placebo at reducing pain intensity in individuals with painful HIV-associated sensory neuropathy of moderate to severe intensity, irrespective of whether they were on antiretroviral therapy or not.Trial Registration ISRCTN 54452526

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“…The use of conventional analgesics is ineffective in the treatment of NP, being necessary the administration of proper drugs as antidepressants, anticonvulsants and opioids 50 . Although the World Health Organization has included drugs for the NP in its list of essential drugs, in the majority of the emergent and developing countries, this list model is deficient in terms of efficient drugs for the NP 51 .…”

Section: Discussionmentioning

confidence: 99%

Detection of pain with neuropathic characteristics in patients with diabetes mellitus assisted in primary care units

Aguiar

Ramos

Bichara

2018

Brazilian Journal of Pain

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World Health Organization essential medicines lists

Cited by 42 publications

References 21 publications

Neuropathic pain in leprosy: symptom profile characterization and comparison with neuropathic pain of other etiologies

Neuropathic pain in leprosy: symptom profile characterization and comparison with neuropathic pain of other etiologies

Randomized, Double-Blind, Crossover Trial of Amitriptyline for Analgesia in Painful HIV-Associated Sensory Neuropathy

Detection of pain with neuropathic characteristics in patients with diabetes mellitus assisted in primary care units

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