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Painful Diabetic Neuropathy Often Inadequately Treated: Presented at ADA

By Jill Stein


ORLANDO, FL -- June 7, 2004 -- Improved management of painful diabetic neuropathy is desperately needed, according to researchers.

On June 5^th, at the 64^th Scientific Sessions of the American Diabetes Association (ADA), Nancy Brandenburg, PhD, with Pfizer, Inc. in New York, presented the results of a community-based cross sectional study undertaken to assess pain severity, medication use and perceived treatment satisfaction among patients with painful diabetic neuropathy (DPN). Patients in the study had been treated by endocrinologists, neurologists, anesthesiologists, and primary care physicians.

Distal symmetric sensorimotor polyneuropathy is the most common diabetic peripheral neuropathy and affects between 16.3% and 50% of patients with diabetes.

Questionnaires were completed by 255 patients with a known history of DPN between April and October 2003. "Our results showed that pain levels remained high and satisfaction with pain management remained low despite extensive treatment," said Dr. Brandenburg.

The mean age of the study population was 61 years, the mean duration of diabetes was 12 years, and the mean duration of diabetic neuropathy was 6.4 years.

The study revealed that a majority (90.6%) of patients had painful diabetic peripheral neuropathy for at least 1 year prior to the survey. About three-quarters of the patients reported moderate-to-severe average and worst pain severity.

In addition, 75.3% of patients had used prescription medications for painful diabetic peripheral neuropathy for at least 1 year prior to the survey.

Most of the patients had used a range of prescription medications for the relief of painful diabetic neuropathy in the week before they completed the questionnaire - 79.2% had used at least one drug while 52.1% had taken at least 2. Overall, 46.7% of patients reported using non-steroidal anti-inflammatory drugs (NSAIDs). "This is disappointing given that this class of drugs has not been approved for this indication," Dr. Brandenburg said.

Few patients reported using amitriptyline and gabapentin, both of which have been recommended as first-line treatments for neuropathic pain.

Overall, 41.9% of patients recruited through primary care physician reported using polytherapy from more than 1 of the following therapeutic classes: opioids, NSAIDs, antiepileptic drugs, tricyclic antidepressants, second-generation antidepressants, sedative/hypnotics and anxiolytics.

Only 22.7% of patients felt that their prescribed medications were extremely or very effective, and only 22.4% were extremely or very satisfied with their medications.



The study was sponsored by Pfizer Global Pharmaceuticals.

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