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Therapeutic utility of palmitoylethanolamide in the treatment of neuropathic pain associated with various pathological conditions: a case series
Abstract
Palmitoylethanolamide (PEA), an endogenous fatty acid amide, has been demonstrated to bind to a receptor in the cell nucleus – the peroxisome proliferator–activated receptor – and performs a great variety of biological functions related to chronic and neuropathic pain and inflammation, as has been demonstrated in clinical trials. These include peripheral neuropathies such as diabetic neuropathy, chemotherapy-induced peripheral neuropathy, carpal tunnel syndrome, sciatic pain, osteoarthritis, low-back pain, failed back surgery syndrome, dental pains, neuropathic pain in stroke and multiple sclerosis, chronic pelvic pain, postherpetic neuralgia, and vaginal pains. Probably due to the fact that PEA is an endogenous modulator as well as a compound in food, such as eggs and milk, no serious side effects have been reported, nor have drug–drug interactions. This article presents a case series describing the application and potential efficacy and safety of PEA in the treatment of various syndromes associated with chronic pain that is poorly responsive to standard therapies.
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PEA to protect against chemotherapy-induced painful polyneuropathy
Chemotherapy-induced neuropathic pain (patient 1) must be taken into account for both the associated disability and distress, but also to optimize the chemotherapy itself. Recently, the effect of PEA on pain and nerve functions in patients with chemotherapy-induced painful neuropathy was assessed.26 In brief, 20 patients undergoing thalidomide plus bortezomib treatment for multiple myeloma received 300 mg PEA twice daily for 2 months, starting after chemotherapy-induced neurotoxicity was established. Although no variable returned to normal, pain and all neurophysiological measures – assessing Aα, Aβ, and Aδ fibers – significantly improved. These results suggest a possible neuroprotective effect of PEA on myelinated nerve fibers. Importantly, concomitant PEA treatment allowed the maintenance of chemotherapeutic dose without further deterioration of nerve functions. The ability to continue chemotherapy in patients suffering from neuropathic pain, instead of stopping or reducing therapy, would clearly impact positively on survival rates also. A multicenter double-blind study evaluating the efficacy and safety of PEA in chemotherapy-induced neuropathic pain is currently in progress.
Conclusion
PEA represents a promising addition to our therapeutic armamentarium for neuropathic pain, with potential for good tolerability and a low propensity for side effects.
Full Article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3500919/
Micronized Palmitoylethanolamide Reduces the Symptoms of Neuropathic Pain in Diabetic Patients
Abstract
The present study evaluated the effectiveness of micronized palmitoylethanolamide (PEA-m) treatment in reducing the painful symptoms experienced by diabetic patients with peripheral neuropathy. PEA-m, a fatty acid amide of the N-acylethanolamine family, was administered (300 mg twice daily) to 30 diabetic patients suffering from painful diabetic neuropathy. Before treatment start, after 30 and 60 days the following parameters were assessed: painful symptoms of diabetic peripheral neuropathy using the Michigan Neuropathy Screening instrument; intensity of symptoms characteristic of diabetic neuropathic pain by the Total Symptom Score; and intensity of different subcategories of neuropathic pain by the Neuropathic Pain Symptoms Inventory. Hematological and blood chemistry tests to evaluate metabolic control and safety were also performed. Statistical analysis (ANOVA) indicated a highly significant reduction in pain severity (P < 0.0001) and related symptoms (P < 0.0001) evaluated by Michigan Neuropathy Screening instrument, Total Symptom Score, and Neuropathic Pain Symptoms Inventory. Hematological and urine analyses did not reveal any alterations associated with PEA-m treatment, and no serious adverse events were reported.
These results suggest that PEA-m could be considered as a promising and well-tolerated new treatment for symptomatology experienced by diabetic patients suffering from peripheral neuropathy.
Effect of micronized PEA on each single neuropathic pain symptom assessed by Total Symptom Score (TSS). The intensity and frequency of pain, burning, paresthesia, and numbness, evaluated by TSS, show a significant mitigation (P < 0.0001) after 60 days of treatment compared to baseline. This effect persists even one month after treatment discontinuation.
Full Study: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3996286/
DISCLAIMER:
The information provided on this page is for educational and informational purposes only. The information provided is not, nor is it intended to be, a substitute for professional advice or care. Please seek the advice of a qualified health care professional in the event something you have read here raises questions or concerns regarding your health.
No claims are made here about benefits of PEA supplement in any medical condition, as PEA (not a prescription item) is governed by TGA in Australia. Research is shown for readers education only.
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