Doctors treating diabetes patients for nerve-pain symptoms should consider Pfizer Inc. (PFE)’s Lyrica, the best-studied drug for the condition, among 13 underutilized treatments, new guidelines suggest.
Lyrica, with sales topping $3 billion last year, was the only medicine that ranked in the top tier of the recommendations as having “very strong” research supporting it, according to the first guidelines for the condition issued today by the American Academy of Neurology. Twelve additional treatments were “probably effective” and should be weighed by physicians to meet the individual needs of each patient.
About 16 percent of people with diabetes develop pain and numbness from nerve damage caused by high blood-sugar levels, according to the report. About 40 percent of patients with nerve pain aren’t being treated for it, said guideline author Vera Bril, professor of medicine at the University of Toronto.
“The whole field has so many options, it gets confusing,” Bril said in a telephone interview from Honolulu, where the guidelines were presented at the neurology academy’s annual meeting. “You have to choose the treatment that’s most suitable for the patient.”
Researchers combed through 2,234 research reports to find the 79 most relevant studies, Bril said. One of the 13 recommended medicines with the greatest potential benefit is a 50-year-old depression treatment called amitriptyline. The drug wasn’t included in the top level of recommendations because the studies for it weren’t as comprehensive as more recent clinical trials, Bril said.
The guidelines also identified nine treatments that aren’t recommended to treat the nerve pain, including the epilepsy drugs Trileptal, made by Novartis AG (NOVN), and Lamictal, by GlaxoSmithKline, as well as magnetic-field treatment and low- intensity laser therapy.
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