Finally: An Effective Way of Regenerating Nerves Damaged by Neuropathy

Robert Odell
2019 Biomedical Journal of Scientific & Technical Research  
In 2011 Dr. Bril and her associates from three major specialties published an exhaustive study of all the published treatments for painful peripheral neuropathy (PPN) from 1960 until July of 2008 and concluded that certain pharmaceuticals met Class I evidence-based standards for treating PPN [1]. One year later Dr. Bril noted that pharmaceuticals did not help the majority of PPN patients who received them, had significant adverse side effects and that "interventions aimed at nerve regeneration
more » ... nerve regeneration may need to be employed" [2]. In 2015, Finnerup [3] and colleagues performed a systematic review and meta-analysis of the data describing pharmacotherapy for neuropathic pain for the IASP; they concluded that the "inadequate response to drug treatments constitutes a substantial unmet need in patients with neuropathic pain." In 2016, Richard Rosenquist, MD of the Cleveland Clinic presented to the ASRA meeting his systematic review and meta-analysis of the available data concerning the pharmacologic treatment for peripheral neuropathy and concluded that it was "miserable, ... frustrating, ... and maybe even appalling" [4] . In 2017, the Cochrane [5] group released a meta-analysis of 37 Class I studies that covered 5914 participants who received high dose gabapentin to treat their PPN. They documented that less than 60% of the patients reduced their pain by 50% or more while over 60% had adverse side effects. Experts in the field of evidence based medicine state that "Real evidence-based medicine makes the ethical care of the patient its top priority" [6]. Hippocrates teaches the basic ethical principle of the Art of Medicine when he states "As to diseases, make a habit of two things --to help, or at least to do no harm". A large number of Class I studies show that pharmaceuticals treat PPN better than placebo; given the dismal results, how can we then claim to practice medicine ethically when our treatments help less than 60% of patients while harming more than 60% of patients who receive them? The World Medical Association Declaration of Helsinki states: "in the treatment of an individual patient, where proven interventions do not exist or known interventions have been ineffective, the physician after seeking expert advice, with the informed consent from the patient or legally authorized representative, may use an unproven intervention if in the physician's judgement it offers hope of saving life, reestablishing health, or alleviating suffering. This intervention should subsequently be made the object of research, designed to evaluate its safety and efficacy. In all cases, new information must be recorded and, where appropriate, made publicly available [7]." My goal in this short article is to make this information publicly available. This small case review/editorial review data from two private practices which document how an "unproven intervention" offers a safe and effective way to treat PPN. As such it meets the WMA Declaration of Helsinki request to record and evaluate its safety and efficacy.
doi:10.26717/bjstr.2019.22.003815 fatcat:5c7tjtzmrvhybnzmdplihmwplu