Condition

Peripheral Neuropathy

Nerve damage causing pain and numbness

206M

People Affected

Active Trials

6.2M

New Cases/Year

25K

Deaths/Year

Treatment Rankings

Ranked by evidence volume first. Medicine has spent centuries ranking things by vibes. This is an improvement.

Duloxetine

80% Effectiveness• 88% Confidence• 60% Safety• 43 trials• 25K participants

HIGH EvidenceExcellent ValueDose: 30-60 mg daily

Find Trials

Comparative Safety Scale(Higher is safer)

Cyanide☠️

Meth💀

Cigarettes🚬

Chemo☢️

Alcohol🍺

Morphine💊

Antibiotics💉

Tylenol💊

Exercise🏃

Water💧

DangerousModerateSafe

Time to Effect

1-2 weeks

Duration

lifetime

Response Rate

55%

Remission Rate

12%

Number Needed to Treat (NNT)

Number Needed to Harm (NNH)

Common Side Effects:

Nausea: 25%

Dry mouth: 15%

Dizziness: 12%

Constipation: 10%

Annual Cost of Care

Drug Cost

$250

Monitoring

$250

Side Effects

$100

Total Annual

$600

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.07

ICER

$20,000/QALY

Cost per Remission

$5,000

Cost per Responder

$1,090.91

Treatment Outcomes

Primary Outcomes

Average Daily Pain Score (NRS 0-10)6.8/10

-35% (-2.4 points)

Worst Pain Score (NRS 0-10)8.0/10

-30% (-2.4 points)

Pain Interference with Sleep (BPI-SF 0-10)6.0/10

-25% (-1.5 points)

Secondary Benefits

Health-Related Quality of Life (SF-36 Bodily Pain subscale)35/100

+25% (+9 points)

Depressive Symptoms (PHQ-9 score 0-27)12/27

-30% (-3.6 points)

Physical Functioning (SF-36 Physical Functioning subscale)40/100

+20% (+8 points)

Common Side Effects

Nausea

+25%

Dry mouth

+15%

Dizziness

+12%

Clinical Trial Phases:

Phase 3Phase 4

Pregabalin

80% Effectiveness• 88% Confidence• 58% Safety• 154 trials• 20K participants

HIGH EvidenceGood ValueDose: 150-600 mg daily in 2-3 divided doses

Find Trials

Comparative Safety Scale(Higher is safer)

Cyanide☠️

Meth💀

Cigarettes🚬

Chemo☢️

Alcohol🍺

Morphine💊

Antibiotics💉

Tylenol💊

Exercise🏃

Water💧

DangerousModerateSafe

Time to Effect

1 week

Duration

lifetime

Response Rate

50%

Remission Rate

Number Needed to Treat (NNT)

Number Needed to Harm (NNH)

Common Side Effects:

Dizziness: 25%

Somnolence: 25%

Peripheral edema: 8%

Weight gain: 7%

Annual Cost of Care

Drug Cost

$400

Monitoring

$250

Side Effects

$100

Total Annual

$750

Cost-Effectiveness

GOOD

QALYs Gained

0.07

ICER

$65,000/QALY

Cost per Remission

$9,375

Cost per Responder

$1,500

Treatment Outcomes

Primary Outcomes

Daily Pain Score6.5/10 (NRS)

-35% (-2.3 points)

Sleep Interference Score6.0/10 (NRS)

-30% (-1.8 points)

Short-form McGill Pain Questionnaire (SF-MPQ) Total Score25/45 points

-35% (-8.8 points)

Secondary Benefits

Health-Related Quality of Life (SF-36 Physical Component Summary)35/100 points

+12% (+4.2 points)

Anxiety Severity (HADS-A)12/21 points

-25% (-3.0 points)

Daily Activity Interference Score6.0/10 (NRS)

-25% (-1.5 points)

Common Side Effects

Dizziness

+25%

Somnolence

+25%

Peripheral edema

+8%

Clinical Trial Phases:

Phase 3Phase 4

Venlafaxine

75% Effectiveness• 85% Confidence• 60% Safety• 5 trials• 18K participants

HIGH EvidenceExcellent ValueDose: 75-225 mg daily (extended-release)

Find Trials

Comparative Safety Scale(Higher is safer)

Cyanide☠️

Meth💀

Cigarettes🚬

Chemo☢️

Alcohol🍺

Morphine💊

Antibiotics💉

Tylenol💊

Exercise🏃

Water💧

DangerousModerateSafe

Time to Effect

1-2 weeks

Duration

lifetime

Response Rate

55%

Remission Rate

12%

Number Needed to Treat (NNT)

Number Needed to Harm (NNH)

Common Side Effects:

Nausea: 25%

Insomnia: 20%

Dizziness: 15%

Increased blood pressure: 7%

Annual Cost of Care

Drug Cost

$200

Monitoring

$250

Side Effects

$100

Total Annual

$550

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.07

ICER

$25,000/QALY

Cost per Remission

$4,583.33

Cost per Responder

$1,000

Treatment Outcomes

Primary Outcomes

Average Pain IntensityNRS (0-10) score: 6.8

-35% (-2.4 points)

Worst Pain IntensityNRS (0-10) score: 8.2

-30% (-2.5 points)

Pain InterferenceBPI-SF Pain Interference (0-10): 6.0

-25% (-1.5 points)

Secondary Benefits

Sleep InterferenceBPI-SF Sleep Interference (0-10): 7.0

-20% (-1.4 points)

Health-Related Quality of LifeEQ-5D-5L VAS (0-100) score: 55

+10% (+5.5 points)

Depression SymptomsPHQ-9 score (0-27): 12

-25% (-3.0 points)

Common Side Effects

Nausea

+25%

Insomnia

+20%

Dizziness

+15%

Clinical Trial Phases:

Phase 3Phase 4

Gabapentin

75% Effectiveness• 83% Confidence• 62% Safety• 72 trials• 30K participants

MODERATE EvidenceExcellent ValueDose: 900-3600 mg daily in 3 divided doses

Find Trials

Comparative Safety Scale(Higher is safer)

Cyanide☠️

Meth💀

Cigarettes🚬

Chemo☢️

Alcohol🍺

Morphine💊

Antibiotics💉

Tylenol💊

Exercise🏃

Water💧

DangerousModerateSafe

Time to Effect

1-2 weeks

Duration

lifetime

Response Rate

48%

Remission Rate

Number Needed to Treat (NNT)

Number Needed to Harm (NNH)

Common Side Effects:

Dizziness: 20%

Somnolence: 20%

Peripheral edema: 7%

Fatigue: 5%

Annual Cost of Care

Drug Cost

$180

Monitoring

$250

Side Effects

$100

Total Annual

$530

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.06

ICER

$15,000/QALY

Cost per Remission

$7,571.43

Cost per Responder

$1,104.17

Treatment Outcomes

Primary Outcomes

Average Daily Pain Score6.8 points on an 11-point scale (0-10)

-35% (-2.4 points)

Pain Interference with Sleep6.2 points on an 11-point scale (0-10)

-30% (-1.9 points)

Worst Pain Score8.5 points on an 11-point scale (0-10)

-25% (-2.1 points)

Secondary Benefits

Health-Related Quality of Life55/100 on EQ-5D Visual Analogue Scale

+10% (+5.5 points)

Physical Functioning40/100 on SF-36 Physical Functioning subscale

+12% (+4.8 points)

Number of Painful Days per Month25 days/month

-20% (-5 days/month)

Common Side Effects

Dizziness

+20%

Somnolence

+20%

Peripheral edema

+7%

Clinical Trial Phases:

Phase 3Phase 4

Amitriptyline

70% Effectiveness• 80% Confidence• 50% Safety• 25 trials• 35K participants

MODERATE EvidenceExcellent ValueDose: 10-150 mg daily

Find Trials

Comparative Safety Scale(Higher is safer)

Cyanide☠️

Meth💀

Cigarettes🚬

Chemo☢️

Alcohol🍺

Morphine💊

Antibiotics💉

Tylenol💊

Exercise🏃

Water💧

DangerousModerateSafe

Time to Effect

2-4 weeks

Duration

lifetime

Response Rate

55%

Remission Rate

12%

Number Needed to Treat (NNT)

Common Side Effects:

Dry mouth: 40%

Sedation/Drowsiness: 30%

Constipation: 20%

Dizziness/Orthostatic hypotension: 15%

Annual Cost of Care

Drug Cost

$90

Monitoring

$300

Side Effects

$200

Total Annual

$590

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.06

ICER

$10,000/QALY

Cost per Remission

$4,916.67

Cost per Responder

$1,072.73

Treatment Outcomes

Primary Outcomes

Pain Intensity (NRS 0-10)6.5/10

-35% (-2.3 points)

Sleep Interference due to Pain (NRS 0-10)7.0/10

-40% (-2.8 points)

Neuropathic Pain Symptom Inventory (NPSI) Total Score50/100

-30% (-15 points)

Secondary Benefits

Quality of Life (SF-36 Bodily Pain Scale)35/100

+20% (+7 points)

Depressive Symptoms (BDI-II Total Score)22/63

-25% (-5.5 points)

Pain Interference with General Activity (PEG scale 0-10)7.0/10

-30% (-2.1 points)

Common Side Effects

Dry mouth

+40%

Sedation/Drowsiness

+30%

Constipation

+20%

Clinical Trial Phases:

Phase 3Phase 4

Topical Capsaicin (8% patch)

65% Effectiveness• 80% Confidence• 80% Safety• 8 trials• 8K participants

MODERATE EvidenceExcellent ValueDose: One 8% patch applied for 60 minutes

Find Trials

Comparative Safety Scale(Higher is safer)

Cyanide☠️

Meth💀

Cigarettes🚬

Chemo☢️

Alcohol🍺

Morphine💊

Antibiotics💉

Tylenol💊

Exercise🏃

Water💧

DangerousModerateSafe

Time to Effect

1-2 weeks

Duration

Applied every 3 months

Response Rate

45%

Remission Rate

Number Needed to Treat (NNT)

Common Side Effects:

Application site pain: 70%

Application site erythema: 60%

Burning sensation: 50%

Annual Cost of Care

Drug Cost

$3,600

Monitoring

$1,200

Side Effects

$50

Total Annual

$4,850

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.03

ICER

$40,000/QALY

Cost per Remission

$161,666.67

Cost per Responder

$10,777.78

Treatment Outcomes

Primary Outcomes

Average Daily Pain Score7.0/10 NRS (0=no pain, 10=worst possible pain)

-35.7% (-2.5 points)

Worst Pain Score (BPI-SF)8.0/10 NRS (0=no pain, 10=worst possible pain)

-35% (-2.8 points)

Neuropathic Pain Symptom Inventory (NPSI) Total Score50/100 NPSI score (0=no symptoms, 100=worst symptoms)

-35% (-17.5 points)

Pain Interference with General Activity (BPI-SF)6.5/10 NRS (0=no interference, 10=complete interference)

-30.8% (-2.0 points)

Secondary Benefits

Pain Interference with Sleep (BPI-SF)7.0/10 NRS (0=no interference, 10=complete interference)

-28.6% (-2.0 points)

Health-Related Quality of Life (EQ-5D VAS)50/100 EQ-5D VAS (0=worst health, 100=best health)

+20% (+10 points)

Depression Score (HADS-D)10/21 HADS-D score (0-7=normal, 8-10=mild, 11-14=moderate, 15-21=severe)

-20% (-2.0 points)

Common Side Effects

Application site pain

+70%

Application site erythema

+60%

Burning sensation

+50%

Clinical Trial Phases:

Phase 3Phase 4

Topical Lidocaine (5% patch)

60% Effectiveness• 75% Confidence• 85% Safety• 7 trials• 9K participants

MODERATE EvidenceExcellent ValueDose: Up to 3 patches for up to 12 hours/day

Find Trials

Comparative Safety Scale(Higher is safer)

Cyanide☠️

Meth💀

Cigarettes🚬

Chemo☢️

Alcohol🍺

Morphine💊

Antibiotics💉

Tylenol💊

Exercise🏃

Water💧

DangerousModerateSafe

Time to Effect

30 minutes to 2 hours

Duration

Applied daily as needed

Response Rate

38%

Remission Rate

Number Needed to Treat (NNT)

Common Side Effects:

Application site erythema: 8%

Application site edema: 5%

Application site pruritus: 5%

Annual Cost of Care

Drug Cost

$2,400

Monitoring

$150

Side Effects

$20

Total Annual

$2,570

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.02

ICER

$35,000/QALY

Cost per Remission

$128,500

Cost per Responder

$6,763.16

Treatment Outcomes

Primary Outcomes

NRS (Numeric Rating Scale) for Average Pain Intensity6.8/10

-30.9% (-2.1/10)

Brief Pain Inventory (BPI) - Average Pain Severity6.5/10

-27.7% (-1.8/10)

Short-form McGill Pain Questionnaire (SF-MPQ) - Pain Rating Index (PRI) total score25/45

-28% (-7.0/45)

Secondary Benefits

Brief Pain Inventory (BPI) - Pain Interference with General Activity6.0/10

-25% (-1.5/10)

Brief Pain Inventory (BPI) - Pain Interference with Sleep7.2/10

-25% (-1.8/10)

EQ-5D-5L Health State Index (Quality of Life)0.65

+12.3% (+0.08)

Common Side Effects

Application site erythema

+8%

Application site edema

+5%

Application site pruritus

+5%

Clinical Trial Phases:

Phase 3Phase 4