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Review

Combination Therapy for Neuropathic Pain: A Review of Recent Evidence

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Department of Anesthesiology, Resuscitation and Pain Management, Hospital Universitari de Bellvitge, 08907 L’Hospitalet de Llobregat, Spain
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Department of Clinical Pharmacology, Hospital Universitari de Bellvitge, 08907 L’Hospitalet de Llobregat, Spain
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Pharmacology Unit, Department of Pathology and Experimental Therapeutics, School of Medicine and Health Sciences, IDIBELL, University of Barcelona, 08907 L’Hospitalet de Llobregat, Spain
*
Author to whom correspondence should be addressed.
Academic Editor: Stefan Evers
J. Clin. Med. 2021, 10(16), 3533; https://doi.org/10.3390/jcm10163533
Received: 6 June 2021 / Revised: 31 July 2021 / Accepted: 9 August 2021 / Published: 11 August 2021
(This article belongs to the Special Issue Pharmacological Management of Chronic Pain)
Pharmacological treatment is not very effective for neuropathic pain (NP). A progressive decrease in the estimated effect of NP drugs has been reported, giving rise to an increase in the use of the multimodal analgesic approach. We performed a new independent review to assess whether more and better-quality evidence has become available since the last systematic review. We evaluated the efficacy, tolerability, and safety of double-blinded randomized controlled trials involving only adult participants and comparing combination therapy (CT: ≥2 drugs) with a placebo and/or at least one other comparator with an NP indication. The primary outcome assessed was the proportion of participants reporting ≥50% pain reductions from baseline. The secondary outcome assessed was the proportion of drop-outs due to treatment-emergent adverse events. After removing duplicates, 2323 citations were screened, with 164 articles assessed for eligibility, from which 16 were included for qualitative analysis. From the latter, only five lasted for at least 12 weeks and only six complied with the required data for complete analysis. CT has been adopted for years without robust evidence. Efforts have been made to achieve better-quality evidence, but the quality has not improved over the years. In this regard, guidelines for NP should attempt to make recommendations about CT research, prioritizing which combinations to analyze. View Full-Text
Keywords: neuropathic pain; combination therapy; pharmacotherapy; randomized control trial neuropathic pain; combination therapy; pharmacotherapy; randomized control trial
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MDPI and ACS Style

Serrano Afonso, A.; Carnaval, T.; Videla Cés, S. Combination Therapy for Neuropathic Pain: A Review of Recent Evidence. J. Clin. Med. 2021, 10, 3533. https://doi.org/10.3390/jcm10163533

AMA Style

Serrano Afonso A, Carnaval T, Videla Cés S. Combination Therapy for Neuropathic Pain: A Review of Recent Evidence. Journal of Clinical Medicine. 2021; 10(16):3533. https://doi.org/10.3390/jcm10163533

Chicago/Turabian Style

Serrano Afonso, Ancor, Thiago Carnaval, and Sebastià Videla Cés. 2021. "Combination Therapy for Neuropathic Pain: A Review of Recent Evidence" Journal of Clinical Medicine 10, no. 16: 3533. https://doi.org/10.3390/jcm10163533

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