[an error occurred while processing this directive]

Item #4 

Lidocaine Patch Provides Effective Analgesia for Painful Diabetic Neuropathy

A transdermal patch, Lidoderm (lidocaine 5 percent) appears to provide significant improvement in both pain intensity and pain relief for patients with painful diabetic neuropathy.

That, from the researchers at the clinical meeting of the American Society of Health-System Pharmacists on December 10^th

The results are important, researchers said, because the condition affects more than 50 percent of elderly patients with diabetes and is notoriously difficult to treat effectively.

The lidocaine patch is a targeted peripheral analgesic that has proved effective in treating postherpetic neuralgia. As such, it may be a potentially powerful strategy for treating painful diabetic neuropathy, according to the researchers, led by Stephanie Hart-Gouleau, MD, of the department of anaesthesiology at the University of Rochester School of Medicine, in Rochester, New York, United States.

The multi-centre, three-week, open-label, prospective trial included 56 men and four women aged 18 to 90 years with painful diabetic neuropathy of at least three months' duration and average daily pain ratings of 4 or higher on numeric pain scale.

Patients were treated with up to four lidocaine patches daily applied to areas of maximal peripheral neuropathic pain, in an 18-hours-on, six-hours-off manner. They were permitted to continue their analgesic medication regimen throughout the trial, as long as dosing remained stable.

For the 51 patients who completed the three weeks of treatment, the lidocaine patch provided significant reductions in pain. At baseline, mean overall pain relief from current therapy was 28.8 percent, compared to a mean of 63.1 percent at the end of the three weeks.

The results are encouraging, the researchers said, because the patch provided analgesia without local anaesthesia, and there were no serious treatment-related systemic adverse events or drug-to-drug interactions. The most frequently reported adverse event, which affected seven patients, was application site burning.

The researchers said that in light of the promising nature of the results, additional controlled clinical trials should be undertaken to further characterise the efficacy of the lidocaine patch in treating painful diabetic neuropathy.   

DID YOU KNOW:

Some diabetes patients are getting into trouble because they think all "clear" insulin is rapid acting.
Many patients were taught that "cloudy" insulin is long-acting...and "clear" insulin is rapid-acting.
But this isn’t true anymore.  Lantus (insulin glargine) is clear...but it’s LONG-acting, not rapid-acting.  This is causing confusion. Some patients don’t know to take Lantus just once per day because they think "long-acting" insulin should be cloudy.
Make sure your diabetes patients understand that not all "clear" insulins are rapid-acting. Have them remember which insulin to take by its name...rather than appearance.  Remind them NOT to mix Lantus with other insulins because the onset and duration of the two insulins may be changed.
Also watch for possible confusion between the names Lantus, Lente, and lispro (Humalog).