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Effectiveness of platelet rich plasma (PRP) treatment and its comparison with pregabalin in painful diabetic polyneuropathy: A randomized controlled clinical trial

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Effectiveness of platelet rich plasma (PRP) treatment and its comparison with pregabalin in painful diabetic polyneuropathy: A randomized controlled clinical trial

Author
Shahzad Anwar, Muhammad Waseem Hassan, Gull-a-Rukh Shaukat, Fatima Tirmzi, Muhammad Umer Saeed, Mudassar Aslam
Author affiliations

1Shahzad Anwar, Director School of Pain and Regenerative Medicine, The University of Lahore, CEO Iffat Anwar Medical Complex, Lahore Pakistan;
E-mail: shahzadtirmzi@yahoo.com

2Muhammad Waseem Hassan, Pain Physician & Acupuncturist, Iffat Anwar Medical Complex, Lahore Pakistan;
E-mail:mainwaseem786@yahoo.com

3Gull-a-Rukh Shaukat, Research Scientist & Biostatistician, Iffat Anwar Medical Complex, Lahore, Pakistan;
E-mail: grukhkhan@gmail.com

4Fatima Tirmzi, Medical Student, CMH Lahore Medical College, Lahore, Pakistan; E-mail: ispd.pk@gmail.com

5Muhammad Umer Saeed, Interventional Pain Physician & Anesthetist, Iffat Anwar Medical Complex, Lahore, Pakistan;
E-mail: umer444@hotmail.com

6Mudassar Aslam, Prof. of Anesthesiology, Punjab Institute of Neurosciences (PINS), Lahore, Pakistan;
E-mail: M.mudassar.aslam@gmail.com

Correspondence: Shahzad Anwar;
E-mail:shahzadtirmzi@yahoo.com

Abstract
Background & objective
The most common consequence of diabetes mellitus (DM) is diabetic peripheral neuropathy (DPN), and it has serious clinical implications that can affect patients’ quality of life. There is an urgent need to to discover new methods of treatment, as the medications currently in use for prevention and treatment of DPN are only partially effective and have frequent adverse effects. We aimed to determine and compare the effect of platelet rich plasma (PRP) injection on acupuncture points and pregabalin in painful DPN.
Methodology

A randomized controlled trial was conducted at Iffat Anwar Medical Complex. All the clinically diagnosed patients having neuropathic sign and symptoms of DPN, with type 2 DM diagnosed having an HbA1c level greater than 7.5, both genders aged between 40-70 y were enrolled in the study. After the written informed consent, a total of 60 patients were randomly divided into two groups in a 1:1 ratio. Group I received PRP injections on acupuncture points and Group II received 75 mg pregabalin PO twice daily. The PRP injection treatment was given once a month for three months. Follow up of all patients was conducted every month till three months and after one year for final assessment. All the data was entered and analyzed by SPSS 25.0. The difference among pain, SF-36, sleep quality scale among groups was compared by independent sample t test and before and after difference was observed by paired sample t-test. P < 0.05 was considered as significant.

Results
The VAS scores were significantly decreased in Group I (from 7.47 ± 1.27 to 3.67 ± 1.09; P < 0.05) as compared to Group II (7.30 ± 1.59 to 5.20 ± 1.58, P < 0.05). The neuropathic symptoms scale also showed significant improvement (Group I: 13.50 ± 50 to 8.50 ± 2.30 vs. Group II: 14.93 ± 2.55 to 9.83 ± 2.17, P < 0.05), as well as the quality of life (Group I: 67.77 to 31.50 ± 9.24 vs. Group II:69.37 ± 11.7to 41.20 ± 12.16, P < 0.05) and sleep quality scale (Group I:49.53 ± 12.4 to 27.30 ± 8.03 vs. Group II: 52.13 ± 10.9to 32.60 ± 7.103, P < 0.05).
Conclusion
We conclude that the treatment of diabetic peripheral neuropathy with platelet rich plasma injections at acupuncture points significantly improves the pain scores, quality of sleep and neuropathic symptoms as compared to conventional treatment with 75 mg pregabalin PO twice daily.
Abbreviations
DM- Diabetes Mellitus; DPN- Diabetic Polyneuropathy; LANSS- Leeds Assessment of Neuropathic Symptoms and Signs; PRP- Platelet Rich Plasma; QoL- Quality of Life; SQS- Sleep Quality Scale
Keywords:
Acupuncture; Diabetic Poly Neuropathy; Pain; PRP injections; Quality of Life
Citation

Anwar S, Hassan MW, Shaukat GR, Tirmzi F, Saeed MU, Aslam M. Effectiveness of platelet rich plasma (PRP) treatment and its comparison with pregabalin in painful diabetic polyneuropathy: A randomized controlled clinical trial. Anaesth. pain intensive care 2024;28(1):44-49;
DOI: 10.35975/apic.v28i1.2280

Received

August 07, 2023; Reviewed: August 08, 2923; Accepted: December 21, 2023

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