Evidence map›Paper›PMID 30348206›Full record

ArticleTrials2018

Multicentre, double-blind, crossover trial to identify the Optimal Pathway for TreatIng neurOpathic paiN in Diabetes Mellitus (OPTION-DM): study protocol for a randomised controlled trial.

Dinesh Selvarajah, Jennifer Petrie, David White, Steven Julious, Oscar Bortolami, Cindy Cooper, Mike Bradburn, Amanda Loban, Helen Bowler, Lizzie Swaby and 3 more

Open access · goldAbstract readClinical Trial Protocol
In one paragraph

Article in Trials, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
1.4field-weighted citation impact, top 19% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 15 citations in OpenAlex.

  1. Trial
  2. Review
  3. Diabetic Peripheral Neuropathy.Handbook of experimental pharmacology · 2022
    Article
  4. Review
  5. Review
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 2 institutions in 1 country.

Dinesh SelvarajahDepartment of Oncology and Human Metabolism, Medical School, University of Sheffield, Sheffield, UK.
Jennifer PetrieClinical Trials Research Unit, University of Sheffield, Sheffield, UK. j.petrie@sheffield.ac.uk.ORCID http://orcid.org/0000-0001-6150-6724
David WhiteClinical Trials Research Unit, University of Sheffield, Sheffield, UK.
Steven JuliousMedical Statistics Group, School of Health and Related Research, University of Sheffield, Sheffield, UK.
Oscar BortolamiClinical Trials Research Unit, University of Sheffield, Sheffield, UK.
Cindy CooperClinical Trials Research Unit, University of Sheffield, Sheffield, UK.
Mike BradburnClinical Trials Research Unit, University of Sheffield, Sheffield, UK.
Amanda LobanClinical Trials Research Unit, University of Sheffield, Sheffield, UK.
Helen BowlerSheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
Lizzie SwabyClinical Trials Research Unit, University of Sheffield, Sheffield, UK.
Katie SutherlandClinical Trials Research Unit, University of Sheffield, Sheffield, UK.
Solomon TesfayeSheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
OPTION-DM group
University of Sheffield · GBSheffield Teaching Hospitals NHS Foundation Trust · GB

Funding

Department of Health HTA/15/35/03Health Technology Assessment Programme 15/13/03
6 · The paper itself

Abstract

backgroundThe number of people with diabetes is growing rapidly. Diabetes can cause nerve damage leading to severe pain in the feet, legs and hands, which is known as diabetic peripheral neuropathic pain (DPNP). In the UK, the National Institute for Health and Care Excellence (NICE) recommends amitriptyline, duloxetine, pregabalin or gabapentin as initial treatment for DPNP. If this is not effective, adding one of the other drugs in combination with the first is recommended. NICE points out that these recommendations are not based on robust evidence. The OPTION-DM randomised controlled trial has been designed to address this evidence deficit, with the aims of determining the most clinically beneficial, cost-effective and tolerated treatment pathway for patients with DPNP. METHODS/

designA multicentre, double-blind, centre-stratified, multi-period crossover study with equal allocation to sequences (1:1:1:1:1:1) of treatment pathways. Three hundred and ninety-two participants will be recruited from secondary care DPNP centres in the UK. There are three treatment pathways: amitriptyline supplemented with pregabalin, pregabalin supplemented with amitriptyline and duloxetine supplemented with pregabalin. All participants will receive all three pathways and randomisation will determine the order in which they are received. The primary outcome is the difference between 7-day average 24-h pain scores on an 11-point NRS scale measured during the final follow-up week of the treatment pathway. Secondary outcomes for efficacy, cost-effectiveness, safety, patient-perceived tolerability and subgroup analysis will be measured at week 6 and week 16 of each pathway. DISCUSSION: The study includes direct comparisons of the mainstay treatment for DPNP. This novel study is designed to examine treatment pathways and capture clinically relevant outcomes which will make the results generalisable to current clinical practice. The study will also provide information on health economic outcomes and will include a subgroup study to provide information on whether patient phenotypes predict response to treatment.

trial registrationISRCTN17545443 . Registered on 12 September 2016.

Indexed as

AmitriptylineAnalgesicsCross-Over StudiesDiabetic NeuropathiesDouble-Blind MethodDrug Therapy, CombinationDuloxetine HydrochlorideHumansMulticenter Studies as TopicPain ManagementPain MeasurementPregabalinRandomized Controlled Trials as TopicTime FactorsTreatment OutcomeUnited KingdomAmitriptylineAnalgesicsDuloxetine HydrochloridePregabalinAmitriptylineCrossover trialDiabetesDuloxetinePainful diabetic neuropathyPregabalin

Identifiers

PMID30348206
PMCPMC6196556
OpenAlexW2897746696

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.