Neuropathic pain clinical trials: factors associated with decreases in estimated drug efficacy

Pain
Nanna B FinnerupNadine Attal

Abstract

Multiple recent pharmacological clinical trials in neuropathic pain have failed to show beneficial effect of drugs with previously demonstrated efficacy, and estimates of drug efficacy seems to have decreased with accumulation of newer trials. However, this has not been systematically assessed. Here, we analyze time-dependent changes in estimated treatment effect size in pharmacological trials together with factors that may contribute to decreases in estimated effect size. This study is a secondary analysis of data from a previous published NeuPSIG systematic review and meta-analysis, updated to include studies published up till March 2017. We included double-blind, randomized, placebo-controlled trials examining the effect of drugs for which we had made strong or weak recommendations for use in neuropathic pain in the previously published review. As the primary outcome, we used an aggregated number needed to treat for 50% pain reduction (alternatively 30% pain reduction or moderate pain relief). Analyses involved 128 trials. Number needed to treat values increased from around 2 to 4 in trials published between 1982 and 1999 to much higher (less effective) values in studies published from 2010 onwards. Several factors that chan...Continue Reading

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Citations

Sep 14, 2019·Journal of Neural Transmission·Stevie Lockwood, Anthony H Dickenson
Jul 1, 2020·Clinical Pharmacology and Therapeutics·Kathryn T HallNancy R Cook
Jan 30, 2019·Pain·Jennifer S GewandterRobert H Dworkin
May 16, 2019·Journal of Dental Research·L VaseM Pigg
Dec 14, 2018·Cancers·Marieke H J van den Beuken-van EverdingenElbert A J Joosten
Aug 14, 2019·Frontiers in Neuroscience·Aleksandra VučkovićMariel Purcell
Dec 18, 2020·Arquivos de neuro-psiquiatria·Rogério Adas Ayres de OliveiraDaniel Ciampi de Andrade
Feb 2, 2021·Pain Reports·Robert H DworkinMichael P McDermott
Aug 18, 2020·Trends in Neurosciences·Robert C Coghill
Nov 13, 2020·Pain·Mimmi GillvingSøren H Sindrup
Mar 13, 2021·Brain : a Journal of Neurology·Troels S JensenBrian C Callaghan
Aug 13, 2021·Journal of Biochemical and Molecular Toxicology·Ana C MedeirosWagner F Dos Santos
Aug 28, 2021·Journal of Clinical Medicine·Ancor Serrano AfonsoSebastià Videla Cés
Nov 2, 2021·Journal of Veterinary Internal Medicine·Margaret E GruenB Duncan X Lascelles
Jul 27, 2021·Current Opinion in Neurology·Nadine Attal, Didier Bouhassira

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