Pain: Painful diabetic neuropathy-new choice of first-line therapy?

摘要

Painful diabetic neuropathy seriously affects quality of life (QOL) and the ability to function.1 However, this condition is often unre-ported and more often untreated, with an estimated two out of five cases not receiving care.2 In addition, community-based data suggest that the use and doses of evidenced-based neuropathic pain-related medications are low, which indicates suboptimal management of neuropathic pain.3 For the practicing clinician, this dilemma raises a question: what is the best treatment for the patient with painful diabetic neuropathy? The answer is provided by an evidence-based guideline and treatment algorithms reported by Bril et al.,A on the basis of recommendations made by an expert panel from the US and Canada that was convened by the American Academy of Neurology, the American Association of Neuromuscular and Electrodiagnostic Medicine and the American Academy of Physical Medicine and Rehabilitation. The experts performed a systematic literature review of data published from 1960 to August 2010 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.