Meta AnalysisID 7255

评估糖尿病神经病变的药物干预:一项网状Meta分析

CRD42023454183

What is the comparative efficacy of pharmacological interventions for diabetic neuropathy in providing freedom from pain in patients?

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Meta Analysis Id
7255
Evidence Id
15813
Core Evidence Id
15813
Source Meta Analysis Id
7239
Herb2 Meta Analysis Id
HBMA007239
Crd Id
CRD42023454183
Title
Evaluating Pharmacological Interventions for Diabetic Neuropathy: A Network Meta-Analysis
Review Question
What is the comparative efficacy of pharmacological interventions for diabetic neuropathy in providing freedom from pain in patients?
Study Type Included
We will include only randomized control trials (RCTs) with a comparator population to assess the efficacy of all pharmacological treatments for diabetic neuropathic pain
Condition Being Studied
Pharmacological interventions used to manage diabetic neuropathy. Diabetic neuropathy is a frequent debilitating complication of diabetes mellitus that significantly impacts the quality of life (QoL) and functional abilities of the patient. We aim to integrate the available evidence by a network meta-analysis incorporating the recent studies and utilizing enhanced statistical methods to provide an evidence-based recommendation for guiding clinical decision making on the most effective and safe pharmacological treatments for diabetic neuropathies and optimize patient outcomes.
Participant
Patients experiencing pain attributed to diabetic neuropathy.
Animal
Human Disease Modelled
Intervention
1) Antidepressants a) SNRIs: Duloxetine Venlafaxine Desvenlafaxine b) TCAs: Amitriptyline Nortriptyline Desipramine Imipramine 2) Anticonvulsants (mostly GABA antiseizure medications) Pregabalin Gabapentin Carbamazepine Lacosamide Topiramate 3) Topical analgesics Ketamine, Esketamine, Lidocaine, Pirfenidone, Cannabidiol, Lignocaine OR Capsaicin, Clonidine, NGX-4010, Pregabalin, Pirfenidone 4) Opioids Difelikefalin, tapentadol, oxycodone, fentanyl, morphine, buprenorphine, tramadol, codeine, hydrocodone 5) Aldose Reductase Inhibitors 6) Antiarrhythmic drugs: Mexiletine, Quinidine 7) Other Drugs: Palmitoylethanolamide Xiaoketongbi Formula vs Pregabalin Melatonin Mesenchymal stem cell-like product (PDA-002) vs Placebo Naltrexone Trazodone vs Placebo Teneligliptin Tocovid vs Placebo Topiramate Dextromethorphan coadministered with Quinidine Topical 5% ketamine cream vs placebo 0.1% topical clonidine gel vs placebo Isosorbide dinitrate spray Botulinum toxin type A Alpha lipoic acid Tapentadol extended release An attempt will be made to include all drugs further identified from literature review on pharmacological interventions in diabetic neuropathy.
Comparator Control
Placebo Neurological controls Other classes of drugs
Main Outcome
The primary outcome of this updated network meta-analysis is to assess pain relief in patients with painful diabetic neuropathy. Pain relief can be evaluated through two measures: 1. Dichotomous Outcome - determining the proportion of patients experiencing a pain decrease and 2. Continuous Outcome - utilizing the standardized mean difference (SMD) on a pain scale to evaluate pain relief. To ensure a comprehensive approach, we will conduct a thorough screening of randomized controlled trials (RCTs) and identify other clinically relevant outcomes of measurement. Measures of effect Proportion variable - Risk ratio/Hazard ratio Continuous variable - Mean difference between populations
Outcome Measure
Additional Outcome
Adverse Effects: The study evaluates and reports the most frequent adverse effects and treatment intolerance of the analyzed medications used to treat painful diabetic neuropathy compared to placebo or other neurological controls. Long-term Analgesic Efficacy: The study will also assess the long-term analgesic effect of some drugs. However, data on the long-term efficacy of other drugs will be limited due to a lack of studies with extended follow-up periods. To ensure a comprehensive approach, we will conduct a thorough screening of randomized controlled trials (RCTs) and identify other clinically relevant outcomes of measurement.
Study Method
Intervention, Meta-analysis, Network meta-analysis, Synthesis of qualitative studies, Systematic review
Keyword
Diabetes Mellitus; Diabetic Neuropathies; Freedom; Humans; Network Meta-Analysis; Pain; Patients
Contact
Dr. Mainak Bardhan [email protected]
Organisational Affiliation
Miami Cancer Institute, Baptist Health South Florida, USA King George's Medical University, Lucknow, India Bukovinian State Medical University, Chernivtsi, Ukraine All India Institute of Medical Sciences, Jodhpur, India Nepalese Army Institute of Health Sciences, Nepal Medical College, Kolkata, India Directorate of Factories, Department of Labour, Government of West Bengal, India Department of Neurology, Yale School of Medicine, USA Department of Statistics and Data Science, Weill Cornell Medical College, Cornell University, USA Nepalese Army Institute of Health Sciences, Nepal
Funding Source
Other Selection Criteria
Final Publication
Same Topic Review
Published Protocol
Review Type
Language
English
Country
India, Nepal, Ukraine, United States of America
Review Stage
Review Ongoing
First Submission Date
2023-08-13
Registration Date
2023-08-24
Anticipated Start Date
2023-08-01
Anticipated Completion Date
2024-09-15
Title Cn
评估糖尿病神经病变的药物干预:一项网状Meta分析
Title En
Evaluating Pharmacological Interventions for Diabetic Neuropathy: A Network Meta-Analysis
Bilingual Status
complete