title: Maintenance of the long-term effectiveness of tramadol in treatment of the pain of diabetic neuropathy.
abstract: OBJECTIVE
  The objective of this study was to evaluate the efficacy and safety of tramadol in a 6-month open extension following a 6-week double-blind randomized trial.
  
  
  METHODS
  Patients with painful diabetic neuropathy who completed the double-blind study were eligible for enrollment in an open extension of up to 6 months. All patients received tramadol 50-400 mg/day. Self-administered pain intensity scores (scale 0-4; none to extreme pain) and pain relief scores (scale -1-4; worse to complete relief) were recorded the first day of the open extension (last day of the double-blind phase) and at 30, 90, and 180 days.
  
  
  RESULTS
  A total of 117 patients (56 former tramadol and 61 former placebo) entered the study. On the first day of the study, patients formerly treated with placebo had a significantly higher mean pain intensity score (2. 2+/-1.02 vs. 1.4+/-0.93, P<0.001) and a lower pain relief score (0. 9+/-1.43 vs. 2.2+/-1.27, P<0.001) than former tramadol patients. By Day 90, both groups had mean pain intensity scores of 1.4, which were maintained throughout the study. Mean pain relief scores (2. 4+/-1.09 vs. 2.2+/-1.14) were similar after 30 days in the former placebo and former tramadol groups, respectively and were maintained for the duration of the study. Four patients discontinued therapy due to ineffective pain relief; 13 patients discontinued due to adverse events. The most common adverse events were constipation, nausea, and headache.
  
  
  CONCLUSIONS
  Tramadol provides long-term relief of the pain of diabetic neuropathy.
authors.affiliation: Baylor College of Medicine and Veterans Affairs Medical Center, Houston, TX 77030, USA. yharati@bcm.tmc.edu
authors.forename: Y
authors.initials: Y
authors.lastname: Harati
authors.forename: C
authors.initials: C
authors.lastname: Gooch
authors.forename: M
authors.initials: M
authors.lastname: Swenson
authors.forename: S V
authors.initials: SV
authors.lastname: Edelman
authors.forename: D
authors.initials: D
authors.lastname: Greene
authors.forename: P
authors.initials: P
authors.lastname: Raskin
authors.forename: P
authors.initials: P
authors.lastname: Donofrio
authors.forename: D
authors.initials: D
authors.lastname: Cornblath
authors.forename: W H
authors.initials: WH
authors.lastname: Olson
authors.forename: M
authors.initials: M
authors.lastname: Kamin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000701:Analgesics, Opioid / Q000009:adverse effects / Q000627:therapeutic use*; D044383:Black People; D003929:Diabetic Neuropathies / Q000503:physiopathology*; D004311:Double-Blind Method; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000188:drug therapy*; D010147:Pain Measurement; D014147:Tramadol / Q000009:adverse effects / Q000627:therapeutic use*; D014481:United States; D044465:White People; D001741:Black or African American
chemical_list: D000701:Analgesics, Opioid; D006442:Glycated Hemoglobin; D014147:Tramadol