Pharmacotherapy in patients with painful diabetic neuropathy: what do recent guidelines tell us?

Department of Neurology, University Hospital of Würzburg, Josef-Schneider-Straße 11, 97080 Würzburg, Germany *Author for correspondence: Tel.: +49 931 2012 3763; Fax: +49 931 2012 3697; [email protected] Summary Painful diabetic neuropathy is a common complication of diabetes. Pharmacological and nonpharmacological options are available for symptomatic treatment. Several guidelines have been published recently, evaluating randomized controlled trials and providing evidence-based recommendations on how to treat this condition. This article summarizes the most important recent national and international guidelines on the treatment of painful diabetic neuropathy. The main drug classes and the recommendations of the different guidelines are presented, as well as the results of economic studies on cost–effectiveness. In the different guidelines, first-line recommendations can be found for pregabalin, duloxetine, gabapentin, venlafaxine and tricyclic antidepressants. There is a consensus that treatment and care should take into account patients’ needs and preferences.