EFNS guidelines on the pharmacological treatment of neuropathic pain: 2009 revision

Nadine Attal, MD, PhD

INSERM U987
Pain Evaluation and Treatment Centre
Hôpital Ambroise Paré
Boulogne-Billancourt, France

Initiated or caused by a primary lesion or dysfunction in the nervous system, neuropathic pain is a manifestation of multiple, heterogeneous disorders. The European Federation of Neurological Societies Task Force has recently updated their guidelines for the pharmacologic treatment of neuropathic pain. Evidence generated in a number of recent clinical trials has expanded first- and second-line recommendations for specific painful conditions. Interestingly, although results for one chronic neuropathic condition can often be extrapolated to other disease states, certain etiologies (eg, HIV polyneuropathy) appear to be more resistant to pharmacologic treatment. To improve responder rates, future work should focus on combinations of analgesic agents as well as broadening clinical trials to categorize patients based on clinical phenotypes and specific sensory profiles rather than underlying diseases.

References

Attal N, Cruccu G, Baron R, et al. EFNS guidelines on the pharmacological treatment of neuropathic pain: 2009 revision. Eur J Neurol. 2010 Apr 9.
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