Efficacy and Safety of Ion Channel Modulators in Painful Diabetic Neuropathy
Abstract
Aims: To systematically evaluate the efficacy and safety of ion channel modulators for the treatment of painful diabetic neuropathy (PDN).
Materials and methods: We searched PubMed, Web of Science, Embase, and the Cochrane Library for randomized controlled trials (RCTs) in PDN patients treated with ion channel modulators. The primary outcome was the pain score. Secondary outcomes included the visual analog scale (VAS) score, 30% and 50% pain reduction, patient global impression of change (PGIC), sleep interference score, adverse events, and treatment discontinuation. Independent authors extracted the data and assessed the quality. Heterogeneity among studies was quantified using the I 2 statistic. The analyses were in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines.
Results: A total of 36 RCTs comprising 6611 participants with PDN were included in the analyses, of which 21 were evaluated with calcium channel blockers, 12 with sodium channel blockers, 2 with TRPA1 antagonists, and 1 with P2X3 antagonists. Compared with placebo, ion channel modulators, particularly calcium channel blockers (mirogabalin, pregabalin, gabapentin, crisugabalin) and sodium channel antagonists (oxcarbazepine, lacosamide, lamotrigine, sodium valproate), can significantly reduce pain, VAS, and sleep interference scores, improve PGIC, and increase the proportion of patients achieving 30% and 50% pain reduction. The therapeutic effects…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 6,611 participants or records.
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