Meta-Analysis of Palmitoylethanolamide in Pain Management: Addressing Literature Gaps and Enhancing Understanding.

IF 5.9 2区医学 Q1 NUTRITION & DIETETICS

Nutrition reviews Pub Date : 2025-01-11 DOI:10.1093/nutrit/nuae203

Isabel Viña, Miguel López-Moreno

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引用次数: 0

Abstract

Context: Chronic pain is a debilitating condition that affects a significant proportion of the population. Palmitoylethanolamide (PEA), a naturally occurring fatty acid amide derived from omega-7 fatty acids, has emerged as a safe and effective alternative for pain management and exerts its effects by interacting with the endocannabinoid system, modulating inflammation, and regulating immune responses.

Objective: A comprehensive meta-analysis was conducted to evaluate the efficacy of PEA in alleviating pain across various pathologies, considering the nociceptive, neuropathic, or nociplastic nature of pain.

Data sources: A systematic search was conducted of 4 databases: PubMed, Embase, Scopus, and Cochrane Collaboration Library.

Data extraction: Randomized clinical trials were selected for analysis. This meta-analysis included 18 studies involving 1196 patients.

Data analysis: Continuous variables were assessed using a standard mean difference (SMD). Heterogeneity was evaluated using the χ2 test and I2 statistics. Pain was significantly reduced in the PEA group at 6 weeks (SMD, -0.9; 95% CI, -1.60 to -0.31), 8 weeks (SMD, -0.98; 95% CI, -1.61 to -0.36), and 24-26 weeks (SMD, -1.16; 95% CI, -2.15 to -0.17). Quality of life, including pain-related items, was significantly higher in the PEA group (SMD, -0.61; 95% CI, -0.93 to -0.30). Significant differences in favor of PEA were observed at 4 (SMD, -0.36; 95% CI, -0.65 to -0.07) and 8 weeks (SMD, -0.66; 95% CI, -1.15 to -0.17). Palmitoylethanolamide was effective for all pain types: nociceptive (SMD, -0.74; 95% CI, -1.42 to -0.06), neuropathic (SMD, -0.97; 95% CI, -1.54 to -0.39), and nociplastic (SMD, -0.59; 95% CI, -1.15 to -0.03).

Conclusions: This meta-analysis confirmed that PEA effectively reduces pain and enhances quality of life, with significant benefits observed within 4-6 weeks of treatment. Palmitoylethanolamide is a promising alternative to chronic opioid analgesics, potentially reducing the risk of opioid abuse and dependency.

Systematic review registration: PROSPERO registration no. CRD42024550546.

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棕榈酰乙醇酰胺在疼痛管理中的荟萃分析：解决文献空白并增进理解。

背景：慢性疼痛是一种使人衰弱的疾病，影响了很大一部分人。棕榈酰乙醇酰胺（PEA）是一种天然存在的脂肪酸酰胺，来源于ω -7脂肪酸，已成为一种安全有效的疼痛治疗替代药物，并通过与内源性大麻素系统相互作用，调节炎症和调节免疫反应来发挥其作用。目的：考虑到疼痛的伤害性、神经性或伤害性，进行了一项全面的荟萃分析，以评估PEA减轻各种病理疼痛的疗效。数据来源：系统检索PubMed、Embase、Scopus和Cochrane Collaboration Library 4个数据库。资料提取：随机选择临床试验进行分析。这项荟萃分析包括18项研究，涉及1196名患者。数据分析：使用标准均差（SMD）评估连续变量。采用χ2检验和I2统计量评价异质性。6周时，PEA组疼痛明显减轻(SMD, -0.9；95% CI, -1.60至-0.31)，8周(SMD, -0.98；95% CI, -1.61至-0.36)，以及24-26周(SMD, -1.16；95% CI, -2.15至-0.17)。生活质量，包括疼痛相关项目，PEA组显著更高(SMD, -0.61；95% CI, -0.93至-0.30)。支持PEA的显著差异为4 (SMD, -0.36；95% CI, -0.65至-0.07)和8周(SMD, -0.66；95% CI, -1.15至-0.17)。棕榈酰乙醇酰胺对所有类型的疼痛均有效：伤害性疼痛(SMD, -0.74；95% CI, -1.42至-0.06)，神经性(SMD, -0.97；95% CI, -1.54至-0.39)和致害性(SMD, -0.59；95% CI, -1.15至-0.03)。结论：本荟萃分析证实，PEA有效减轻疼痛，提高生活质量，在治疗4-6周内观察到显著的益处。棕榈酰乙醇酰胺是一种有前景的替代慢性阿片类镇痛药，潜在地降低阿片类药物滥用和依赖的风险。系统评审注册：普洛斯彼罗注册号。CRD42024550546。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Nutrition reviews 医学-营养学

CiteScore

12.20

自引率

1.60%

发文量

121

审稿时长

6-12 weeks

期刊介绍： Nutrition Reviews is a highly cited, monthly, international, peer-reviewed journal that specializes in the publication of authoritative and critical literature reviews on current and emerging topics in nutrition science, food science, clinical nutrition, and nutrition policy. Readers of Nutrition Reviews include nutrition scientists, biomedical researchers, clinical and dietetic practitioners, and advanced students of nutrition.