The use of topical Lidocaine 700 mg medicated plaster (LMP) can effectively relieve pain and improve functional status in patients suffering from painful diabetic peripheral neuropathy (PDPN), as deduced from a study issued in ‘BMJ Open Diabetes Research and Care’. This non-interventional, retrospective 24-week cohort study evaluated the most suitable and effective therapy (LMP versus first-line oral medicines) for the management of PDPN.

This sub-group analysis was based on the routine medical care data from a national pain registry i.e. German Pain eRegistry. Considering the propensity score matching, there were 732 datasets for each treatment group. The variation in the average 24-hour Pain Intensity Index (0 to 100 mm) from baseline after 4 weeks, 12 weeks and 24 weeks’ follow-up and throughout the treatment phase was the primary efficacy endpoint.

About 50% of PDPN patients (aged more than 60 years old) were multimorbid (4 comorbidities per patient on average) and polymedicated (6 non-analgesic medicines on average). After 4 weeks of LMP therapy, there were significant declines in pain intensity and functional improvements in routine activities. The effectiveness was sustained over a period of 24 weeks even when the simultaneous use of analgesics was decreased or stopped and the quality of life (QoL) improved.

Also, the mean change in the primary effectiveness parameter was −30.2 mm (standard error [SE] 0.38) and −17.0 mm (SE 0.51) in the LMP and oral medicines groups. Also, the effectiveness parameters (i.e., average 24-hour pain intensity index (PIX); improvement in PIX; impairment in routine life due to pain and QoL) considerably improved under LMP compared to oral medicines. Not many patients in the LMP group experienced adverse events. Notable outcomes were displayed in terms of physical functioning in the LMP group.

Routine use of LMP can serve as a useful therapy for PDPN given its encouraging benefit/risk profile and a greater decrease in the intake of simultaneous pain-reliever use (92% of patients reduced simultaneous analgesics intake), as concluded.