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Artukoglu BB, Beyer C, Zuloff-Shani A, et al. Efficacy of Palmitoylethanolamide for Pain: A Meta-Analysis. Pain Physician. 2017 Jul;20(5):353-362.
Discipline Area Score
Physician 5 / 7
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  Acute Pain   Chronic Pain
Abstract

BACKGROUND: Palmitoylethanolamide (PEA) is a cannabimimetic compound that has been investigated as an analgesic agent in animal models and clinical trials.

OBJECTIVES: We conducted a meta-analysis to examine the efficacy of PEA for treating pain in randomized, controlled trials.

STUDY DESIGN: Systematic review and meta-analysis.

SETTING: This meta-analysis examined all randomized, controlled trials involving the effect of PEA on pain score.

METHODS: We searched PubMed and Embase for randomized, active or placebo-controlled trials of PEA for the treatment of acute or chronic pain. Our primary outcome was the weighted mean difference in visual analog pain scales of PEA treatment compared to inactive controls.

RESULTS: We identified 10 studies including data from 786 patients who received PEA and 512 controls for inclusion in our systematic review. Eight trials included an inactive control group and were included in the meta-analysis. PEA was associated with significantly greater pain reduction compared to inactive control conditions (WMD = 2.03, 95% CI: 1.19 - 2.87, z = 4.75, P < 0.001). Use of placebo control, presence of blinding, allowance for concomitant treatments, and duration or dose of PEA treatment did not affect the measured efficacy of PEA. All-cause dropout was non-significantly reduced in the PEA group compared to inactive control conditions (RR = 0.36, 95% CI: 0.10 - 1.26, z = -1.60, P = 0.11).

LIMITATIONS: This meta-analysis relied on a relatively small number of trials across a variety of conditions causing pain with differing trial designs. Overall quality of the underlying studies and assessment of side effects were often poor.

CONCLUSIONS: PEA may be a useful treatment for pain and is generally well tolerated in research populations. Further, well-designed, randomized, placebo-controlled trials are needed to provide reliable estimates of its efficacy and to identify less serious adverse events associated with this compound.

KEY WORDS: PEA, palmidrol, palmitoylethanolamide, efficacy, pain, pain management, meta-analysis.

Comments from MORE raters

Physician rater

The potential place for cannabinoids such as Palmitoylethanolamide (PEA) is pain management is of interest. We still don't know its role, in which patients to administer it, at what stage, at what dosing and its risk for side effects including addiction. The present paper shows that further high quality studies are warranted to help defining their use in clinical practice.
Comments from PAIN+ CPN subscribers

Ms. Lesley Singer (9/9/2017 11:16 AM)

I find that more and more patients are asking about cannabinoid products for pain management and I think this is an area which definitely needs more research, as anecdotal evidence is often what drives a lot of people with pain to try them. I think we need to get the evidence based info and get it out there