Hassanien M, Elawamy A, Kamel EZ, et al. Perineural Platelet-Rich Plasma for Diabetic Neuropathic Pain, Could It Make a Difference?. Pain Med. 2019 Jul 12. pii: 5531622. doi: 10.1093/pm/pnz140. (Original study)

OBJECTIVE: To evaluate the clinical effect of perineural platelet-rich plasma (PRP) injection for pain and numbness alleviation in diabetic peripheral neuropathy (DPN).

STUDY DESIGN: A randomized prospective clinical trial.

SETTING: Pain clinic and Rheumatology and Rehabilitation Departments, Assiut University Hospital.

METHODS: Sixty adult patients with type II DM accompanied by DPN of at least six months' duration were assessed by modified Toronto Clinical Neuropathy Score (mTCNS) and randomly allocated into two groups. Group I underwent ultrasound-guided perineural PRP injection and medical treatment, and Group II received medical treatment only. Patients were followed up at months 1, 3, and 6 with regard to pain and numbness visual analog scale (VAS) and mTCNS scores.

RESULTS: Significant improvement was recorded in pain and numbness VAS scale scores in group I vs group II (P = 0.001 during the whole study period for both parameters); at the same time, mTCNS improved in group I in comparison with group II with P = 0.01, 0.001, and <0.001 at months 1, 3, and 6, respectively.

CONCLUSIONS: Perineural PRP injection is an effective therapy for alleviation of diabetic neuropathy pain and numbness and enhancement of peripheral nerve function.

Discipline Area Score
Physician 5 / 7
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Comments from MORE raters

Physician rater

These are interesting preliminary results that need confirmation, assessment of the long term effect and assessment of the applicability in the "real world" setting.

Physician rater

This is a small study with no true sham control group. The authors chose to mention a positive carpal tunnel PRP injection study (which also had no sham group), but failed to mention a recent negative carpal tunnel article:

Physician rater

Almost all type2 diabetes patients suffer from DPN and still we have no well and effective treatment. This study showed that perineural platelet-rich plasma injection found excellent result in reducing symptoms of neuropathy even permanently. Multiple factors including nerve cell regeneration are responsible for such result. It is a very promising treatment option in DPN.

Physician rater

The present paper deals with an injection trial of perineural platelet-rich plasma for diabetic neuropathy. The authors conclude that this injection is an effective and safe modality for the above mentioned pathology. In fact, it can significantly alleviate neuropathic pain and numbness symptoms. Hence, nerve conduction studies showed significant improvement after injection. The manuscript is pretty well-presented and correctly divided into sub-sections. The take-home message is straight forward even for those readers who are not in the field. The flow is linear and the writing is fluid and understandable. No grammar errors have been detected either. This manuscript is overall a good add to the literature.
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