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The Neuropathic Pain Special Interest Group, part of the International Association for the Study of Pain, conducted a systematic review and meta-analysis to update their 2015 recommendations on managing neuropathic pain. The analysis included ≈300 randomized controlled trials of pharmacologic and noninvasive neuromodulation options for managing neuropathic pain; median trial duration was 8 weeks.
The authors restricted their analysis to certain study populations, such as patients with postherpetic neuralgia, diabetic painful polyneuropathy, and central poststroke pain. Notable exclusions were low back pain without radicular pain and fibromyalgia.
Key points include the following:
First-line medications for neuropathic pain are tricyclic antide…