Emerging drugs for diabetic peripheral neuropathy and neuropathic pain

ABSTRACT

Introduction: Diabetic sensorimotor polyneuropathy (DSPN) is a common complication of diabetes.

Areas covered: In this review, the authors discuss the emerging drugs for DSPN, which aim either at improving alleviation of neuropathic pain or addressing the putative mechanisms underlying diabetic neuropathy.

Expert Opinion: Current treatment does not address the sensory deficits and pathogenesis underlying DSPN, so there is an unmet need for treatment options targeting the natural history of the condition. Some of these pathogenetic therapies have demonstrated clinically relevant improvements in neuropathic endpoints in recent randomised controlled trials. Since any effective analgesic monotherapy is known to induce a clinically meaningful response in only some 50% of the patients, there remains a substantial unmet need in patients with neuropathic pain. Advanced knowledge in the neurobiology of neuropathic pain and improved phenotypic profiling have led to a burst of research into novel pharmaceutical approaches. An array of promising molecular entities have reached the clinical stage of development, which should improve our therapeutic armamentarium in the fight against DSPN and neuropathic pain in the foreseeable future.

KEYWORDS:

• Analgesics
• diabetic neuropathy
• neuropathic pain
• pathogenesis
• treatment

Declaration of interest

N Papanas has been an advisory board member of Astra-Zeneca, Boehringer Ingelheim, Merck Sharp & Dohme, Novo Nordisk, Pfizer, Takeda and TrigoCare International; has participated in sponsored studies by Astra-Zeneca, Eli-Lilly, GlazoSmithKline, Merck Sharp & Dohme, Novo Nordisk, Novartis and Sanofi-Aventis; has received honoraria as a speaker for Astra-Zeneca, Boehringer Ingelheim, Eli-Lilly, ELPEN, Merck Sharp & Dohme, Mylan, Novo Nordisk, Pfizer, Sanofi-Aventis and Vianex; and attended conferences sponsored by TrigoCare International, Eli-Lilly, Galenica, Novo Nordisk, Pfizer and Sanofi-Aventis. D Ziegler has been a consultant of TrigoCare International, Meda, Wörwag, Glenmark, Astellas, Teva, Takeda, and Mitsubishi Tanabe, has received honoraria as a speaker for Meda, Berlin-Chemie, Wörwag, Lilly, and Astellas and research grants from Neurometrix and Wörwag. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Additional information

Funding

This paper is not funded.