Transdermal buprenorphine may be an effective therapy for diabetic peripheral neuropathic pain (DPNP). However the treatment was associated with a high rate of adverse events, mostly nausea and/or vomiting.
The findings come from a newly published multi-center, randomized, double-blind, placebo-controlled, parallel-group trial. Ninety-three patients with type 1 or 2 diabetes were enrolled and received either buprenorphine (5μg/h) or placebo patches. All the patients had been experiencing moderate to severe DPNP for a minimum of 6 months on maximal tolerated conventional therapy. The dose was titrated to effect to a maximum of 40μg/h for the study.
Results showed that of those who completed the study, the buprenorphine group had 86.3% who experienced a 30% reduction in average versus baseline pain at week 12. Compared with the 56.6% in the placebo group who experienced the same reduction (P<0.001).
The intention-to-treat analysis, with the same end point, also showed a nonsignificant trend favoring the treatment group (51.7% vs. 41.3%, P=0.175).
However, many patients did not complete the study. Resulting in 37 patients in the buprenorphine group as well as 24 in the placebo group not finishing. Those in the buprenorphine group mostly reported nausea and/or vomiting as their reason for halting treatment.
The authors then concluded, that when tolerated, transdermal buprenorphine is an effective therapy for DPNP. Adding that, “Nausea and constipation need to be managed proactively to more effectively optimize treatment outcomes.” If these side effects can be better managed, this therapy could also prove useful to nerve pain management.
By , , , , , , and
June 2016
Continue reading the full article from The Journal of Rheumatology here.
