The effect of transdermal nitroglycerin on pain control in diabetic patients with peripheral neuropathy.

Arman Taheri,Patricia Khashayar,Afshin Samadi,Arash Farbood,Ramin Heshmat,Mostafa Qorbani,Mohammad Ghorbani,Ghazaleh Ebrahimi Khaneqah

doi:10.1186/s40200-015-0217-3

Abstract

BackgroundDespite high prevalence of diabetic peripheral neuropathy there is no definite treatment for the condition. The present study was conducted to assess the efficacy of transdermal nitroglycerin patch in pain control of patients with DPN.MethodsThis randomized, double-blind, crossover study was conducted on 30 patients with symmetric distal peripheral neuropathy and good glycemic control. The patients were randomly assigned to receive nitroglycerin transdermal and placebo patches in two 4-week stages. The severity of pain and other neuropathic sensory symptoms were assessed at the end of each course.ResultsMean reduction of pain severity was more prominent in the NTG group compared to placebo group of the study (p = 0.048) at least during the first phase of the study. Except for mood and sleep, a significant reduction in all Brief Pain Inventory scores was noted in the drug group (all corrected p < 0.05). SF-MPQ also showed the drug patch to be effective in improving different aspects of pain measured using McGill Pain Questionnaire, except for Role–emotional.ConclusionsIt could be concluded that nitroglycerin plasters can effectively help alleviate pain in patients with diabetic neuropathy.Trial registrationIRCT201308223213N1

Highlights

Despite high prevalence of diabetic peripheral neuropathy there is no definite treatment for the condition
From among the 30 individuals recruited in the study, 10 did not complete the research, eight of them because of the adverse effects of the drug
Studying Numerical Rating Scale (NRS) values in different intervals, using repeated measure ANOVA test, showed more reduction in mean pain scores in drug compared to placebo phase mainly during the pre-washout period of the study (p = 0.045 and 0.048 for the last two measurements of the forth week, respectively) (Fig. 2)

Summary

Introduction

Despite high prevalence of diabetic peripheral neuropathy there is no definite treatment for the condition. The present study was conducted to assess the efficacy of transdermal nitroglycerin patch in pain control of patients with DPN. Peripheral neuropathy is one of the most common complications in patients with long-standing diabetes, and as many as 50 % of patients develop neuropathy by 25 years after diagnosis [2, 3]. Ten percent of the diabetic patients experience pain in association with their diabetic peripheral neuropathy (DPN). DPN represents a diffuse duration-dependent injury to peripheral nerves that has major implications on quality of life, morbidity, and costs [5, 6]. The pain associated with diabetic peripheral neuropathy is a major cause of morbidity in these patients and may have a profound impact on their functioning and well-being

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Results

Discussion

Conclusion