Drug therapy for pain in amyotrophic lateral sclerosis or motor neuron disease

Brettschneider J, Kurent J, Ludolph A, Mitchell JD

Published Online:

November 10, 2010

Amyotrophic lateral sclerosis (ALS), also known as motor neuron disease (MND), is the most common neurodegenerative disorder of the motor system in adults. Pain is a frequent symptom and may have a pronounced impact on quality of life and suffering. Despite an extensive search of different medical databases, this review was not able to identify any randomised controlled trials on drug therapy for pain in ALS. Currently no evidence exists for using one type of treatment over another.

Abstract (click to read)

Background:

Amyotrophic lateral sclerosis (ALS), also known as motor neuron disease (MND), is the most common neurodegenerative disorder of the motor system in adults. Pain in ALS is a frequent symptom especially in the later stages of disease and can have a pronounced influence on quality of life and suffering. Treatment of pain therefore should be recognised as an important aspect of palliative care in ALS.

Objectives:

To systematically review the evidence for the efficacy of drug therapy in relieving pain in ALS. We also aimed to evaluate possible adverse effects associated with the different drugs and their influence on survival and quality of life.

Search strategy:

We searched the following databases: the Cochrane Neuromuscular Disease Group Specialised Register (18 May 2010), the Cochrane Central Register of Controlled Trials (CENTRAL) (2010, Issue 2 in The Cochrane Library), MEDLINE (January 1966 to May 2010), EMBASE (January 1980 to May 2010), CINAHL (January 1982 to May 2010), AMED (January 1985 to May 2010) and LILACS (January 1982 to May 2010). We checked the bibliographies of trials identified and contacted other disease experts to identify further published and unpublished trials.

Selection criteria:

We searched for randomised or quasi-randomised controlled trials on drug therapy for pain in amyotrophic lateral sclerosis.

Data collection and analysis:

We collected data using a specially designed form and analysed them using the Cochrane Review Manager software.

Main results:

We found no randomised or quasi-randomised controlled trials on drug therapy for pain in ALS or MND.

Authors' conclusions:

There is no evidence from randomised controlled trials about the management of pain in ALS. Further research on this important aspect of palliative care in ALS is needed. Randomised controlled trials should be initiated to determine the effectiveness of different analgesics for treatment of pain in ALS.

This record should be cited as:

Brettschneider J, Kurent J, Ludolph A, Mitchell JD. Drug therapy for pain in amyotrophic lateral sclerosis or motor neuron disease. Cochrane Database of Systematic Reviews 2008, Issue 3. Art. No.: CD005226. DOI: 10.1002/14651858.CD005226.pub2

Assessed as up to date:

May 18, 2010

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Primary Review Group:

Neuromuscular Disease Group

Health topics:

Neurology > Motor neurone disorders > Amyotrophic lateral sclerosis/motor neurone disease

Cochrane Summaries^beta

Independent high-quality evidence for health care decision making

Drug therapy for pain in amyotrophic lateral sclerosis or motor neuron disease

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